title: Rheumatoid arthritis mimicking metastatic squamous cell carcinoma.
abstract: We report a case of a cervical rheumatoid nodule in close relation to the hyoid bone mimicking a metastatic carcinoma. A 74-year-old female with a 15-year history of rheumatoid arthritis (RA) on treatment with methotrexate presented with tenderness of the right base of tongue. Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone. Biopsies were unsuccessful and the patient required surgical resection of the mass. A trans-cervical approach was used. Pathology revealed a necrotizing granuloma compatible with rheumatoid etiology. The clinician should be aware that, in a patient with a neck mass, in the presence of active RA, rheumatoid nodules should be part of the differential diagnosis.
authors.affiliation: Otorhinolaryngology - Head and Neck Surgery/Otolaryngology, The University of Houston Health Science Center, Houston, Texas, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomez-Rivera
authors.forename: Adel K
authors.initials: AK
authors.lastname: El-Naggar
authors.forename: Nandita
authors.initials: N
authors.lastname: Guha-Thakurta
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kupferman
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D006928:Hyoid Bone / Q000473:pathology; D009362:Neoplasm Metastasis; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D012218:Rheumatoid Nodule / Q000175:diagnosis / Q000473:pathology; D000077195:Squamous Cell Carcinoma of Head and Neck