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Clinical Problem Solving: Radiology
December 2002

Radiology Quiz Case 2

Author Affiliations
 

R. NICKBRYANMDS. JAMESZINREICHMD

Arch Otolaryngol Head Neck Surg. 2002;128(12):1429. doi:

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.

An ultrasound examination revealed a septated cystic mass in the lateral aspect of the right side of the neck (Figure 2), parallel to the great vessels, without vascular or airway compression. A computed tomographic scan with contrast showed a bilobulated cystic mass in the lateral aspect of the right side of the neck (Figure 3 and Figure 4).

What is your diagnosis?

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