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Clinical Problem Solving
March 2014

Neck Mass in an Adolescent Male

Author Affiliations
  • 1Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
JAMA Otolaryngol Head Neck Surg. 2014;140(3):275-276. doi:10.1001/jamaoto.2013.6230

An adolescent male with no clinically significant medical history presented with a left-sided, anterior neck mass. His only subjective complaint was a feeling of neck “tightness.” Neck examination revealed a left-sided 2 × 3-cm firm, nonmobile, nonerythematous, nontender mass lateral to the cricothyroid membrane extending to the thoracic outlet that did not move with tongue protrusion.

Ultrasonography (US) was performed. A transverse image of the thyroid gland (Figure, A) showed ill-defined hypoechoic areas in the left lobe, suggesting edema and phlegmonous change. A focal hypoechoic area in the medial aspect may represent abscess or necrosis. The overlying soft tissues were diffusely edematous.