Nasopharyngeal Carcinoma with Cystic Cervical Metastasis Masquerading as Branchial Cleft Cyst: A Potential Pitfall in Diagnosis and Management | ||
| Iranian Journal of Otorhinolaryngology | ||
| مقاله 10، دوره 29، شماره 2، 2017، صفحه 117-120 اصل مقاله (303.09 K) | ||
| نوع مقاله: Case Report | ||
| شناسه دیجیتال (DOI): 10.22038/ijorl.2017.8297 | ||
| نویسندگان | ||
| Lum Sai Guan* 1؛ Kong Min Han1؛ Ngan Kah Wai2؛ Mohd Razif Mohamad Yunus1 | ||
| 1Department of Otorhinolaryngology – Head and Neck Surgery, University Kebangsaan Malaysia Kebangsaan Medical Centre (UKMMC), Kuala Lumpur, Malaysia. | ||
| 2Department of Pathology, Hospital Serdang, Selangor, Malaysia. | ||
| چکیده | ||
| Introduction: Most metastatic lymph nodes from head and neck malignancy are solid. Cystic nodes are found in 33% - 61% of carcinomas arise from Waldeyer’s ring, of which only 1.8% - 8% originate are from the nasopharynx. Some cystic cervical metastases were initially presumed to be branchial cleft cyst. This case report aims to highlight the unusual presentation of cystic cervical metastasis secondary to nasopharyngeal carcinoma in a young adult. The histopathology, radiological features and management strategy were discussed. Case Report: A 36-year-old man presented with a solitary cystic cervical swelling, initially diagnosed as branchial cleft cyst. Fine needle aspiration yielded 18 ml of straw-coloured fluid. During cytological examination no atypical cells were observed. Computed tomography of the neck showed a heterogeneous mass with multiseptation medial to the sternocleidomastoid muscle. Histopathological examination of the mass, post excision, revealed a metastatic lymph node. A suspicious mucosal lesion at the nasopharynx was detected after repeated thorough head and neck examinations and the biopsy result confirmed undifferentiated nasopharyngeal carcinoma. Conclusion: Cystic cervical metastasis may occur in young patients under 40 years. The primary tumour may not be obvious during initial presentation because it mimicks benign branchial cleft cyst clinically. Retrospective review of the computed tomography images revealed features that were not characteristic of simple branchial cleft cyst. The inadequacy of assessment and interpretation had lead to the error in diagnosis and subsequent management. Metastatic head and neck lesion must be considered in a young adult with a cystic neck mass. | ||
| کلیدواژهها | ||
| Branchial cleft cyst؛ Metastasis؛ Nasopharyngeal carcinoma | ||
| مراجع | ||
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