Schwannomas are benign, slow-growing tumors originating from the Schwann cells of nerve sheaths. Extracranial schwannomas are rare, particularly in pediatric populations. Here, we report the case of a hypoglossal schwannoma in a 15-year-old male who experienced tongue paresthesia and fasciculations and difficulty swallowing two years before hospital admission. Magnetic resonance imaging showed an oval mass with sharp and regular limits of approximately 45 × 29 × 25 mm in the cranial portion of the right carotid adipose space, caudal to the right carotid and lateral foramen. The patient underwent surgery, and a histological examination confirmed a schwannoma of the hypoglossal nerve. Six months after surgery, the patient was symptom-free. The literature on schwannomas of the hypoglossal nerve is scarce, with only a few previously reported cases in the adult population. Despite their rarity, schwannomas should be considered in the differential diagnosis of masses located in the neck that present with lingual and occasionally auditory symptoms, even in pediatric patients. Surgical resection is recommended and has a low risk of long-term recurrence.

Most fetal anomalies can be detected during the second trimester of chromosomal anomaly screening. However, even an experienced sonographer might fail to notice a fetal neck mass during this screening and would be diagnosed at a later point in time. In this case report, we have followed up on an incidentally detected case of fetal neck mass on antenatal sonography with post-delivery ultrasound and contrast-enhanced computed tomography.

In the treatment of head and neck cancer (HNC), any delay in omit initiation worsens the overall prognosis. Thus, the early start of HNC treatment is crucial. Unfortunately, treatment delays persist in clinical practice. There are several possible reasons for this. One reason is that patients with HNC do not visit an ear, nose, and throat (ENT) doctor. This is because non-ENT doctors (e.g., general practitioners {GPs}) lack expertise in HNC and therefore may unrecognize it. Therefore, guiding patients with suspected HNC symptoms to an otorhinolaryngologist, an HNC specialist, is necessary. To determine the departments that patients with potential HNC symptoms tend to select, we administered a questionnaire survey to 140 participants. Fewer than 60% of respondents indicated they would consult an otorhinolaryngologist even when recognizing symptoms suggestive of HNC. Notably, a significantly low percentage of respondents mentioned they would consult an otorhinolaryngologist for neck masses. Public awareness of HNC symptoms, especially the association between a neck mass and HNC, is limited. The lack of understanding by the general public regarding the relationship between neck masses and HNC is a challenge to prompt initiation of treatment.

Carotid body tumors are rare benign tumors that arise in the carotid space of neck typically presenting as soft to firm, painless swelling in the neck. While specific imaging characteristics have been previously described for carotid body tumors, we report a new imaging sign in three cases of carotid body tumors on computed tomography angiography.

BACKGROUND: Surgeon-performed ultrasound guided fine needle aspiration (SUS-FNA) reduces the time to diagnosis and treatment of head and neck pathology. Although it has been validated in the investigation of thyroid pathology, there is a paucity of evidence to support its use in lateral neck masses. This study aims to determine the accuracy and adequacy of SUS-FNA in the investigation of lateral neck masses.
METHODS: A retrospective cohort analysis was performed of patients who underwent a SUS-FNA for lateral neck mass between June 2018 and October 2022 at a single institution. Pathologist reports were reviewed to determine the rate of FNA sample adequacy. A comparison was made between FNA cytology results and final histopathological diagnosis following surgical excision in a subset of patients to determine FNA accuracy.
RESULTS: A total of 110 SUS-FNAs were performed on lateral neck masses. Diagnostic adequacy of SUS-FNA was determined to be 91% (100/110). When analysing the subset of patients who proceeded to surgical excision, the diagnostic accuracy of SUS-FNA was determined to be 88% (38/43).
CONCLUSIONS: SUS-FNA results in high adequacy rates with good diagnostic accuracy in the investigation of lateral neck masses. This tool has great potential in reducing treatment delay in the management of head and neck cancer.

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We report on a 70-year-old male patient admitted to the internal medicine department for evaluation of a right cervical mass. He had been treated with antibiotics as an outpatient by his primary care doctor. Upon admission the patient was asymptomatic, but within a few hours his cervical mass enlarged; this enlargement was confined to the right sternocleidomastoid muscle. Complete blood investigations including serology and autoimmunity were negative. The neck scan and MRI were in favour of myositis. No other lesions were found either in the nasal fibre-optic exam or in the thoracic-abdominal-pelvic scan. The biopsy of the muscle showed a lymphoplasmacytic inflammatory infiltrate of the perimysium. The diagnosis of focal myositis was made. The patient clinically improved during hospitalisation with complete resolution of symptoms without any specific intervention.
CONCLUSIONS: A thorough clinical examination is essential in the evaluation and characterisation of cervical masses.The diagnostic approach must be rigorous in order not to ignore potentially serious diseases.A high level of clinical suspicion is needed in the diagnosis of focal myositis.

Lipomas are slow growing tumors rarely found in children. We report a very rare case of an intermuscular fibrolipoma found deep within the posterior triangle of the neck. A 3 year old child was brought with the complaints of right sided neck mass and an inability to fully turn his head for two months. Ultrasound and computed tomography of the neck suggested a diagnosis of intermuscular lipoma. The patient was successfully managed by complete surgical resection of the mass. Histopathological examination confirmed the diagnosis as intermuscular fibrolipoma. Due to the rarity of the case, we are prompted to report it.

UNASSIGNED: Rosai-Dorfman-Destombes disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a rare form of non-Langerhans cells histiocytosis. It has a wide-ranging variability in presentation since first described in 1969 but much of its characteristics in children remain unknown.
UNASSIGNED: A retrospective chart review of children diagnosed with RDD at a tertiary care children\'s hospital was conducted from 2000 to 2021.
UNASSIGNED: Twelve RDD patients were identified, with an average age of 7 years (SD 4.3). Males comprised 58% of the cohort, and African American ethnicity was most common (42%). Nodal RDD was found in 7 patients (58%). Nine patients (75%) presented RDD within the head and neck, 6 of whom had nodal RDD. The most common presentation was cervical lymphadenopathy, which most often involved levels V (67%), II (56%), III (44%), and I (11%), in order of frequency. Recurrence and persistence of disease after initial treatment was common, with 5 (42%) being disease free at the time of the last follow up. Fifty-eight percent (7/12) developed recurrence or had persistent disease and 4 required adjuvant systemic treatment with corticosteroids and/or chemotherapy. One patient succumbed after developing treatment related acute myelodysplastic leukemia (t-AML) from chemotherapy used to treat recurrent RDD.
UNASSIGNED: Pediatric RDD presents at a young age and most commonly involving cervical lymphadenopathy. Ongoing surveillance in the setting of persistence or recurrence without clearly defined prognostic risk factors is important.

BACKGROUND: Although thyroid lymphoma is an uncommon malignant disease, it is still important to consider in patients with an enlarging neck mass. Primary thyroid lymphoma (PTL) can be cured with chemoimmunotherapy without thyroidectomy, thus avoiding surgical complications as well as hormonal replacement therapy.
OBJECTIVE: The study aims to evaluate the clinical features, risk factors, and treatment outcomes of PTL.
METHODS: Retrospective study.
METHODS: The study was carried out in the Oncology Center of Mansoura University.
METHODS: The study included 13 PTL patients (4 male and 9 female) with a median age of 58 years [range, 43-73 years].
METHODS: The patients were treated with rituximab ± anthracycline-based regimens.
METHODS: Demonstration of the clinicopathological features of PTL patients.
RESULTS: In this study, 9 patients (69.3%) were diagnosed by fine-needle aspiration and core needle biopsy, 1 patient (7.7%) by hemithyroidectomy, and 3 patients (23%) by total thyroidectomy. The common stage of presentation was early stage, comprising 7 patients (53.8%), followed by advanced stage, comprising 6 patients (46.2%). Three patients (23.07%) had a history of Hashimoto\'s thyroiditis. Two patients (15.4%) tested positive for hepatitis C virus. One patient (7.7%) had rheumatoid arthritis. One patient had a double malignancy in the form of thyroid carcinoma and thyroid lymphoma. Eight patients (61.6%) presented with high-intermediate and high International Prognostic Index risk. Four patients (30.8%) achieved completed remission, and the median disease-free survival was 20.58 months. The median overall survival was 11.5 months (range: 2.03-126.03 months).
CONCLUSIONS: The cooperation of a multidisciplinary team of physicians, surgeons, and pathologists is necessary to detect PTL early and enhance its outcome through significant improvement of diagnostic and therapeutic strategies.