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Cervical abscess

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Right-sided neck swelling. Ultrasound showed a 45 mm solid-cystic mass deep to the sternocleidomastoid muscle. Necrotic lymph node? Abscess?

Patient Data

Age: 35 years
Gender: Male

CT Neck

ct

There is a multilobulated predominantly hypoattenuating mass, extending under the right sternocleidomastoid muscle, from the posterior cervical space to the submandibular space anteriorly, involving the regions of the IIB and III lymph nodes levels, displacing the structures of the carotid and pharyngeal spaces medially and the right submandibular salivary gland anteriorly. This mass measures approximately 6.8 x 4.8 x 5.2 cm (longitudinal x anteroposterior x transverse) and demonstrates a vivid peripheral contrast enhancement. Extensive involvement of the prevertebral space from C1 to C7.

Prominent bilateral lymph nodes with normal morphology.

Case Discussion

The findings are those of a large deep cervical parapharyngeal abscess on the right with extension to the prevertebral space.

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