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Lateral cystic neck masses in adults: a ten-year series and comparative analysis of diagnostic modalities

Published online by Cambridge University Press:  17 February 2022

G H Jones Open the ORCID record for G H Jones [Opens in a new window] ,
D Chudek ,
K Davies ,
N Upile ,
A Kinshuck ,
A Triantafyllou ,
J C Fleming  and
N J Roland
G H Jones*
Affiliation:
ENT Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
D Chudek
Affiliation:
ENT Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
K Davies
Affiliation:
ENT Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
N Upile
Affiliation:
ENT Department, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, Liverpool, UK
A Kinshuck
Affiliation:
ENT Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
A Triantafyllou
Affiliation:
Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
J C Fleming
Affiliation:
ENT Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
N J Roland
Affiliation:
ENT Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
*
Author for correspondence: Mr G H Jones, ENT Department, Liverpool University Hospitals NHS Foundation Trust, Lower Lane, Liverpool, L9 7AL, UK E-mail: huw4@doctors.org.uk
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Abstract

Background

In adults, the solitary lateral cystic neck mass remains a diagnostic challenge with little solid material to target for cytology and few clues on imaging modalities to suggest underlying malignancy.

Method

This study was a retrospective review of patients presenting with a lateral cystic neck mass to a tertiary academic head and neck centre over a 10-year period.

Results

A total of 25 of 157 cystic lesions were subsequently malignant on paraffin section histopathology, with the youngest patient being 42 years. In the age cohort over 40 years, 30 per cent of males and 10 per cent of females were diagnosed with malignancy. The ipsilateral palatine tonsil was the most common primary site (50 per cent). A total of 85 per cent of cases demonstrated integrated human papillomavirus infection. Age, male sex and alcohol were significant risk factors on univariate analysis. Ultrasound-guided fine needle aspiration cytology and magnetic resonance imaging represented the most accurate pre-open biopsy tests.

Conclusion

The authors of this study advocate for a risk-stratified, evidence-based workup in patients with solitary lateral cystic neck mass in order to optimise timely diagnosis.

Keywords

Squamous Cell Carcinoma Of Head And NeckBranchial Cleft CystBranchiomaLymphatic MetastasisPapillomavirus Infections
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 3 , March 2023 , pp. 312 - 318
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr G H Jones takes responsibility for the integrity of the content of the paper

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