Kadkhodayan Yasha, Yano Motoyo, Cross DeWitte T
Department of Interventional Neuroradiology, Consulting Radiologists Ltd, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
J Neurointerv Surg. 2014 Nov;6(9):e44. doi: 10.1136/neurintsurg-2013-010844.rep. Epub 2013 Nov 4.
A 58-year-old woman presented with a palpable mass at the base of the left neck which she had first noticed 12 years previously, shortly after abdominal surgery. The mass had progressively enlarged, resulting in dysphagia, dyspnea and occasional pain. Imaging showed a septated but otherwise simple cystic mass extending into the mediastinum and containing lymphocytic fluid on aspiration. A diagnosis of the rare entity of a thoracic duct cyst with supraclavicular extension was made. The patient opted for percutaneous sclerotherapy of the lesion, which was performed using glacial acetic acid. This resulted in complete resolution of the mass with one treatment. After exclusion of other causes of cystic left supraclavicular masses including cystic neoplasms and pseudoaneurysms of the carotid or subclavian arteries, direct puncture sclerotherapy can be safe and effective.
一名58岁女性，左颈部根部可触及肿块，她12年前腹部手术后不久首次发现该肿块。肿块逐渐增大，导致吞咽困难、呼吸困难并偶尔疼痛。影像学检查显示为一个有分隔但其他方面为单纯性的囊性肿块，延伸至纵隔，抽吸时内含淋巴细胞性液体。诊断为罕见的伴有锁骨上延伸的胸导管囊肿。患者选择对该病变进行经皮硬化治疗，使用冰醋酸进行操作。一次治疗后肿块完全消退。在排除了左锁骨上囊性肿块的其他病因，包括囊性肿瘤以及颈动脉或锁骨下动脉假性动脉瘤后，直接穿刺硬化治疗可以是安全有效的。
