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. A neck mass is very commonA variety of clinical condiitons are associated with a mass in the neckDifferential diagnosis Accurate diagnosis. . An asymptomatic solitary neck mass in the lateral aspect of the neck in an adult should be considered a metastatic lymph node until proved otherwise.. E
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1. Solitary neck mass Chest surgery
2. A neck mass is very common
A variety of clinical condiitons are associated with a mass in the neck
Differential diagnosis
Accurate diagnosis
3. An asymptomatic solitary neck mass in the lateral aspect of the neck in an adult should be considered a metastatic lymph node until proved otherwise.
4. Etiology Congenital
Traumatic
Inflammatory
Neoplastic
5. Congenital Pediatric age group
Benign: thyroglossal duct cyst,branchial cleft yst cystic hygroma, hemangioma and hemangiolymphangiomma,
Lateral: inflammatory or hyperplastic LN
Maligant is rare: lymphoma thyroid ca or other soft tissue tumor
6. Traumatic Rarely produce a solitary mass
History
Hematoma, sternomastoid tumor AVM
7. Inflammation Sign of inflammation and tenderness
Chronic : TB, mononucleosis , toxoplasomosis cat-scratch fever,
Hyperplastic lymphadenopathy in AIDS
8. Neoplastic Benign: Lipoma , neurofibromaCarotic bod y tumorn neurogenic tumor adenoma of thyroid and parathyroid.
Malignant: primary or metastatic
9. Primary: tumor of salivary gland,soft tissue sarcoma, primary ca of thyroid and parathyroid gland , lymphoma
10. Metastatic: the most frequently encountered solitary mass in the lateral neck in adult is a metastatic lymph node
From head and neck below clavicle from the lung, from abdomen.
11. 80s simple rule for solitary neck mass If benign tumors of the thyroid glad are excluded, nearly 80% of neck mass in adults are malignant.
80% are metastatic
80% arise from primary sites above the clavicle.
80% are metastatic SCC.
14. We can predict a potential primary site according to the location of a metastatic lymph node presenting as a solitary neck mass
15. Diagnosis History
Physical examination
Fine neddle aspiration or biopsy: sensitivity , lymphoma is difficult
Excional biopsy : small or movable
Incisional biopsy : large , multiple unresectable.
16. Open biopsy , it is best performed in the operating room
To proceed with definite surgical treatment if indicated