A 67-year-old man presented to the otolaryngology outpatient clinic with a computed tomogram (CT) that showed air in the right side of his neck. He had a 4-month history of increasing pain and slight swelling around the right side of the clavicle. His medical history included renal cell carcinoma and chronic lymphocytic lymphoma. He had also undergone a left radical nephrectomy 4 years earlier as well as mediastinoscopy with node sampling and video-assisted thoracic surgery (VATS) to resect a metastatic renal cell carcinoma of the left lower lobe. He reported having a chronic cough for 3 years but denied fever, dyspnea, dysphagia, or trauma.
Teker AM, Lorenz RR, Lee WT, Murthy SC. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2007;133(9):940. doi:10.1001/archotol.133.9.940