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BACKGROUND
A 58-year-old man with a history of hypertension, type 2 diabetes mellitus, and hyperlipidemia presents to the emergency department with a large, painless mass on the anterior aspect of the neck. He reports that the mass developed over the past 3 days, preceded by a sore throat and mild subjective fevers for several days. He denies having any associated dysphagia, hoarseness, drooling, or stridor. He denies having a history of neck or oropharyngeal trauma, weight loss, night sweats, or cough. He has no history of tobacco use or alcohol abuse.
On physical examination, the patient is a healthy-appearing Asian man in no apparent distress. No hoarseness is noted. The oropharynx has no notable lesions or apparent mass effect. On the anterior aspect of the neck is a 2 X 3-cm, smooth, soft, ovoid mass extending from the hyoid to the cricoid cartilage. The mass elevates when the patient swallows or protrudes his tongue. On direct visualization with flexible laryngoscopy, the posterior part of the nasopharynx appears normal. The airway is clear and patent, without evidence of mass or external compression. The true vocal cords appear normal.
Laboratory results, including the CBC, are within normal limits. A CT scan of the neck is ordered.
What is the diagnosis? |
Hint
This condition occurs through abnormal development of an embryological remnant of the head and neck. |
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Author:
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Mary B. White, MD,
West Los Angeles Veterans Affairs Medical Center,
Los Angeles, Calif
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eMedicine
Editor:
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Erik D. Schraga, MD,
Staff Physician,
Kaiser Permanente,
Santa Clara Medical Center, Calif
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