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  • Title: [Cystic neck mass. Cervical cleft cyst or lymph node metastasis?].
    Author: Schouten CS, Akrum RA, van der Velden LA.
    Journal: Ned Tijdschr Geneeskd; 2013; 157(3):A5087. PubMed ID: 23328013.
    Abstract:
    While most cystic neck masses are cervical cleft cysts, it is known that lymph node metastasis from a squamous cell carcinoma in Waldeyer's ring may undergo cystic degeneration and can mimic cervical cysts, leading to a mistaken diagnosis. A 54-year-old male presented with features of a cervical cleft cyst, which later proved to be a lymph node metastasis from a supraglottic laryngeal carcinoma. A 47-year-old male presented with an abscessing lymphadenitis; this turned out to be a metastasis of an unknown primary tumor. Investigations should include ultrasound-guided FNA (fine-needle aspiration) performed by an experienced radiologist. However, FNA outcomes are often inconclusive. In patients who are highly suspected of having a malignancy (those with a history of smoking and alcohol abuse), a panendoscopy with biopsies and tonsillectomy, preferably conducted by an otolaryngologist specialised in head and neck cancer, should be considered.
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