Presentation
Painless left neck mass for two years. Slowly increasing in size for 6 months and associated with difficulty in swallowing. No other symptoms.
Patient Data
Lobulated non-calcified soft tissue density lesion in the left neck with tracheal shift to the right side.
Large multiseptated cystic lesion in the left neck. No solid component or internal vascularity is seen in it.
Large simple fluid density cystic lesion in the left neck posterior to the sternocleidomastoid muscle and lateral to the carotid vessels, extending inferiorly below the clavicle in to the superior mediastinum and apex of the left axilla. The lesion is displacing the smoothly abutted left-sided great neck vessels, left thyroid lobe and trachea to the contra-lateral side. Few thin septations are seen in it. No calcifications or solid component is seen in it. No abnormal enhancement is seen in it.
Procedure: Left neck cystic mass excision.
Diagnosis: Lymphangioma/cystic hygroma.
Case Discussion
Above mentioned imaging features are suggestive of a benign looking left neck cystic lesion, likely a cystic hygroma/lymphangioma. Other possible differential diagnosis includes second branchial cleft cyst and cystic/necrotic lymph node which is however, unlikely.
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