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JAMA Surgery Clinical Challenge
September 2015

A Symptomatic Cervical Mass

Author Affiliations
  • 1Rhode Island Hospital, Providence
  • 2Department of Surgery, Warren Alpert Medical School at Brown University, Providence, Rhode Island
JAMA Surg. 2015;150(9):909-910. doi:10.1001/jamasurg.2015.0692

A woman in her mid-50s presented to the clinic with a 6-month history of progressive swelling and pain on the right side of her neck. The patient described a history of sleep apnea, a remote transient ischemic attack with left-sided weakness, and a prior thyroidectomy. She had increasing fatigue during the last 6 months, as well as worsening anxiety. On physical examination, the neck was supple, with no palpable masses or lymphadenopathy, and had a well-healed transverse neck incision. Magnetic resonance imaging revealed a 1.1-cm, round, partially enhancing, cystic mass near the tail of the parotid gland that appeared hypointense on T2-weighted imaging (Figure 1). An enlarged and distended venous structure that measured up to 7 mm was also visualized in the area. Laboratory work revealed no abnormalities.

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