title: [Cystic neck mass. Cervical cleft cyst or lymph node metastasis?].
abstract: While most cystic neck masses are cervical cleft cysts, it is known that lymph node metastasis from a squamous cell carcinoma in Waldeyer's ring may undergo cystic degeneration and can mimic cervical cysts, leading to a mistaken diagnosis. A 54-year-old male presented with features of a cervical cleft cyst, which later proved to be a lymph node metastasis from a supraglottic laryngeal carcinoma. A 47-year-old male presented with an abscessing lymphadenitis; this turned out to be a metastasis of an unknown primary tumor. Investigations should include ultrasound-guided FNA (fine-needle aspiration) performed by an experienced radiologist. However, FNA outcomes are often inconclusive. In patients who are highly suspected of having a malignancy (those with a history of smoking and alcohol abuse), a panendoscopy with biopsies and tonsillectomy, preferably conducted by an otolaryngologist specialised in head and neck cancer, should be considered.
authors: Leids Universitair Medisch Centrum, afd. Keel-, Neus- en Oorheelkunde en Heelkunde van het Hoofd-Halsgebied, Leiden, the Netherlands. cs.schouten@vumc.nl
authors: Charlotte S
authors: CS
authors: Schouten
authors: Ralph A E
authors: RA
authors: Akrum
authors: Lilly-Ann
authors: LA
authors: van der Velden
mesh_terms: D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003560:Cysts / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000175:diagnosis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*