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Clinical Challenge
May 2018

Tubular Neck Mass

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
JAMA Otolaryngol Head Neck Surg. 2018;144(5):453-454. doi:10.1001/jamaoto.2018.0019

A man in his 60s presented to a tertiary care center after several months of having right-sided lateral neck pain. He described the pain as “electric” and “stabbing.” He reported no numbness of the region and had not experienced any other symptoms, including new neck masses. His medical history was significant for obstructive sleep apnea, gastroesophageal reflux disease, a right ear skin cancer excised by a dermatologist, and coronary artery disease with angina on stress test. His physical examination revealed a well-healed excision site of the right ear without new skin lesions. His facial nerve was fully intact. He had full strength of the shoulder and no numbness of the right ear or cheek. Palpation of the lateral neck demonstrated a mass running along the lateral border of the sternocleidomastoid (SCM) muscle. Magnetic resonance imaging (MRI) showed an elongated enhancing tubular structure along the lateral surface of the right SCM muscle (Figure 1).