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Clinical Problem Solving
February 2014

An Enlarging Neck Mass

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
  • 2Massachusetts Eye and Ear Infirmary, Boston
  • 3Massachusetts General Hospital, Boston
JAMA Otolaryngol Head Neck Surg. 2014;140(2):175-176. doi:10.1001/jamaoto.2013.6075

A woman in her 70s presented with an enlarging right neck mass over the previous 6 months. Prior neck ultrasonography and a computed tomography (CT) scan showed a heterogeneous echogenic right thyroid mass with tracheal displacement and a noncalcified pulmonary nodule on the left side. A radioactive iodine scan revealed a large cold nodule. A positron emission tomographic (PET) scan showed increased fludeoxyglucose F 18 avidity of both the right thyroid mass and the lung nodules. Results from the initial fine-needle aspiration (FNA) from the outside institution were nondiagnostic.

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