A 40-YEAR-OLD WOMAN presented with a 5-month history of swelling in the right side of her neck. The swelling was painless, had increased over the prior month, and had caused mild dysphagia and respiratory discomfort in the weeks before she presented.
Physical examination revealed a soft, nontender, nonfluctuant mass measuring approximately 10 cm in greatest dimension (Figure 1). The mass was not fixed to surrounding structures; the trachea was midline; carotid pulses were palpable bilaterally; and no other neck masses were palpable. Fiberoptic endoscopy showed a normal nasopharynx and larynx, with no apparent bulging of the lateral pharyngeal wall.