Pankhania Miran, Judd Owen, Conboy Peter J
A&E Department, University Hospitals of Leicester, Leicester, UK.
BMJ Case Rep. 2011 May 16;2011:bcr1120103478. doi: 10.1136/bcr.11.2010.3478.
A neck mass, which rapidly increases in size over several weeks, is concerning for all involved. When accompanied by other symptoms suggesting sinister underlying pathology, efficient management and rapid diagnosis are vital. The causes may include primary or metastatic carcinoma, or lymphoreticular malignancy. Other non-sinister pathology may account for the swelling such as reactive lymph nodes or benign neoplasms. A benign neoplasm of the lymphatic system known as a lymphangioma may rarely be the cause of a mass in the neck in adults. More commonly found in infants, with approximately 40% found at birth, they are seldom encountered in adults. In children, they have the propensity to infiltrate into and around muscles and neurovascular structures, occasionally leading to difficult surgical excision. The authors present an unusual case of an adult patient with an expansile mass in the supraclavicular fossa of insidious onset. It was associated with dysphagia and hoarseness of voice.
一个在几周内迅速增大的颈部肿块，让所有相关人员都忧心忡忡。当伴有其他提示潜在恶性病变的症状时，有效的管理和快速诊断至关重要。病因可能包括原发性或转移性癌，或淋巴网状恶性肿瘤。其他非恶性病变也可能导致肿胀，如反应性淋巴结或良性肿瘤。一种称为淋巴管瘤的淋巴系统良性肿瘤很少会成为成人颈部肿块的病因。淋巴管瘤在婴儿中更常见，约40%在出生时就已发现，在成人中很少见。在儿童中，它们有浸润到肌肉和神经血管结构及其周围的倾向，偶尔会导致手术切除困难。作者报告了一例不寻常的成年患者，其锁骨上窝有一个隐匿性起病的膨胀性肿块，伴有吞咽困难和声音嘶哑。
