Cystic masses of the supraclavicular fossa: clinical features and diagnostic strategies☆
Received 10 February 2009 published online 02 November 2009. Corrected Proof
Abstract
Purpose
Cystic masses of the supraclavicular fossa (SCF) are uncommon. The diverse anatomical structures within the SCF create an extended differential diagnosis for any mass arising in the SCF. This study describes the presenting symptoms, radiologic findings, medical and surgical management, and posttreatment outcomes of various cystic mass presenting in the SCF. A review of the literature and diagnostic and therapeutic algorithms are also provided.
Methods
A retrospective study of an academic tertiary care head and neck cancer center was done. Seven cases of treated cystic masses of the SCF were identified. Diagnostic and therapeutic interventions are described.
Results
Cross-sectional imaging and needle aspiration or biopsy were obtained in all 7 cases. Aspirates accurately differentiated benign from malignant lesions in 6 cases, identified the offending pathology in 3 cases, and provided inoculum for culture-directed antibiotic therapy in 1 case. Surgical intervention was used for definitive therapy in 6 cases. All patients achieved complete resolution of signs and symptoms of the mass.
Conclusions
Effective evaluation of a cystic lesion within the SCF mandates a thorough understanding of the anatomy and differential diagnosis. A well-defined algorithm allows successful management of benign and malignant lesions in the SCF.
Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear Infirmary and the Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA
Corresponding author. Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA. Tel.: +1 617 573 3654; fax: +1 617 573 3939.
☆ The authors of this manuscript have no disclosures or conflicts of interest to report.
ABSTRACT