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Clinical Challenge
March 2018

Adult-Onset Giant Cervical Mass

Author Affiliations
  • 1Department of Otorhinolaryngology, Near East University, Faculty of Medicine, Nicosia, Cyprus
  • 2Department of Radiology, Near East University, Faculty of Medicine, Nicosia, Cyprus
JAMA Otolaryngol Head Neck Surg. 2018;144(3):264-265. doi:10.1001/jamaoto.2017.2468

An otherwise healthy man in his 40s was referred to our ear, nose, and throat department for the evaluation of a giant, left-sided neck mass. He reported no antecedent neck trauma or neck infection, nor any history of swelling during childhood. He experienced dyspnea, limitation of neck movements, and neck tightness owing to the bulkiness of the lesion. The swelling had been present for approximately 12 months, and the growth was gradual and continuous. Contrast-enhanced T1- and T2-weighted magnetic resonance imaging (MRI) revealed a 15 × 7-cm homogenous ovoid bilobulated cystic mass in the left lateral region of the neck with displacement of the surrounding musculature and vascular structures but no sign of invasion. The imaging of the lesion revealed fibrous septae in the central and inferior parts, with extension to the supraclavicular region (Figure, A and B). After written informed consent was obtained, the patient underwent total excision of the cystic mass through an apron flap incision combined with T-incision for preservation of cranial nerve XI and sternocleoidomastoid muscle (Figure, C).

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