title: Cystic cervical metastases: incidence and diagnosis using fine needle aspiration biopsy.
abstract: BACKGROUND
  Seventeen patients presenting with a cystic cervical metastasis were identified after either having undergone excision of a cyst, initially diagnosed as a branchial cyst but subsequently found to be malignant, or after having had fluid aspirated from a neck mass that ultimately proved to be malignant while undergoing fine needle aspiration biopsy.
  
  
  METHODS
  Patients had primary cancer documented at a variety of primary sites, including hypopharynx (3 patients), oropharynx (2 patients), lower lip (2 patients), nasopharynx, supraglottis, oral cavity, and prostate (1 patient each). Six cases (35%) remained occult.
  
  
  RESULTS
  In nearly half of the cases (8 of 17), there was no evidence of the primary cancer at presentation. In the same period, 25 branchial cysts were encountered, giving an incidence of unsuspected carcinoma in cervical cysts of 24% (8 of 33).
  
  
  CONCLUSIONS
  In contrast to previous studies in which smaller numbers of patients underwent the procedure, we found fine needle aspiration to be very helpful in the assessment of these lesions, having a sensitivity of 73% in diagnosing malignancy.
authors.affiliation: Department of Otolaryngology, South Infirmary-Victoria Hospital, Cork, Ireland. sheahanp@eircom.net
authors.forename: Patrick
authors.initials: P
authors.lastname: Sheahan
authors.forename: Gerard
authors.initials: G
authors.lastname: O'leary
authors.forename: Gary
authors.initials: G
authors.lastname: Lee
authors.forename: Jim
authors.initials: J
authors.lastname: Fitzgibbon
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000556:secondary*; D006801:Humans; D015994:Incidence; D018191:Lymphangioma, Cystic / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000453:epidemiology / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity