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December 1971

The Resident's Page

Author Affiliations

1721 Pine St, Philadelphia 19103; The Methodist Hospital, Houston 77025

Arch Otolaryngol. 1971;94(6):574-577. doi:10.1001/archotol.1971.00770070874015

PATHOLOGIC QUIZ CASE 1  Robert E. Fechner, MD, HoustonA 32-year-old man appeared with a mass in the lower, anterior part of the left side of his neck. He had first noticed this about two weeks before admission while lifting heavy weights. He denied any other symptoms, including dyspnea and dysphagia. He had never had surgery in this region. On physical examination, a soft mass was palpable just above the clavicle. It measured 5×3 cm, was nontender, and felt cystic. The mass would partially disappear behind the clavicle on deep inspiration. Results of roentgenograms of the neck and chest were normal as were results of a scan of the thyroid. The neck was explored and a poorly circumscribed, multiloculated cystic mass was present in the subcutaneous and deeper soft tissues. It extended into the anterior superior mediastinum and was removed with sharp dissection. Histologic sections are seen in Fig 1

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