9/18/2023 0 Comments Lump in neck moves around![]() There was also no sign of an aneurysm or dissecting component. 5 However, in this patient, ultrasonography of the neck was performed and revealed a variant of the right common carotid artery from the left common carotid artery at the base of the neck crossing midline, causing a palpable mass. 4 Meticulous examination is crucial as direct surgical excision, FNA, or an open biopsy may be hazardous and cause torrential bleeding. 1 A thorough history should be taken from patients presenting with a pulsatile neck mass, for example, AV fistula are commonly caused by trauma or medical procedures 2, 3 and pseudoaneurysms mostly appear following an arterial catheterization. The presence of a pulsatile anterior neck mass leads to suspicion of vascular anomalies like arteriovenous (AV) fistula, aneurysms, pseudoaneurysms, and carotid body tumors. ![]() A solitary thyroid nodule remained a possibility in this case as the neck mass moved with deglutition. The absence of any signs and symptoms of infection excluded cervical lymphadenitis and tubercular or non-tubercular lymphadenopathy. Since the swelling was in the anterior neck region, we excluded lateral neck swellings like branchial cysts, solitary lymphatic cysts, and carotid body tumors. The patient's age immediately ruled out the common anterior neck masses found in the pediatric age group such as thyroglossal duct cysts or lymphangioma (cystic hygroma). To achieve an accurate diagnosis it is important to use a combination of anatomical, pathological, and radiological approaches guided by a thorough history and physical examination. Diagnosis of an anterior neck mass is mostly limited to solitary thyroid nodule followed by thyroglossal duct cyst. Laryngoscopy was performed, and no abnormality was seen.Īnterior neck mass is a common presentation to the otorhinolaryngology clinic. Systemic examination was normal, and she had normal thyroid function test results. No bruits were audible and all peripheral pulses were felt. There were no other masses in the head, neck, or other parts of her body. Neck examination revealed a non-tender, pulsatile, well-circumscribed anterior neck mass measuring 3 × 3 cm, which moved slightly with deglutition but not with tongue protrusion. Oral cavity examination revealed no abnormality. No one else in the family had any similar complaints.Ĭlinically, she appeared comfortable with no audible noisy breathing. She had no signs or symptoms of hypo- or hyperthyroidism. According to her, there were no obstructive symptoms present. There was no history of dysphagia, odynophagia, or hoarseness. The patient complained of a painless anterior neck mass for the past 10 years that had been slowly increasing in size. A 65-year-old female with underlying bronchiectasis was referred to our otorhinolaryngology clinic for further management of a right solitary thyroid nodule.
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