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

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. This study was a retrospective review of patients presenting with a lateral cystic neck mass to a te...

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Bibliographic Details
Published in:Journal of laryngology and otology 2023-03, Vol.137 (3), p.312-318
Main Authors: Jones, G H, Chudek, D, Davies, K, Upile, N, Kinshuck, A, Triantafyllou, A, Fleming, J C, Roland, N J
Format: Article
Language:English
Subjects:
Accuracy
Adult
Age groups
Alcohol use
Biopsy
Branchioma - diagnosis
Branchioma - pathology
Carcinoma, Squamous Cell - pathology
Cellular biology
Comparative analysis
Cysts
Cytology
Diagnosis, Differential
Endoscopy
Female
Head & neck cancer
Head and Neck Neoplasms - diagnostic imaging
Histopathology
Human papillomavirus
Humans
Magnetic resonance imaging
Main Article
Male
Malignancy
Medical diagnosis
Neck
Neck - diagnostic imaging
Neck - pathology
Paraffin
Patients
Regression analysis
Risk factors
Squamous cell carcinoma
Thyroid cancer
Tomography
Tonsil
Ultrasonic imaging
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Summary: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. 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. 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. 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.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215122000469