The laterocervical unique masses a challenging pathology
Costan Anca-Roxana2, Vulpoi Carmen1, Vicol Carmen1, Crumpei Felicia2, Ferariu Dan2, Popescu Eugenia1 & Costan Victor-Vlad1
Introduction: Extrathyroidal unique laterocervical masses are infrequent, and their etiological diagnosis is difficult. Since clinical and imagistic features cannot distinguish between different ethiologies, morphological data are mandatory in order to establish a precise therapeutic strategy. Therefore the initial treatment is surgery, followed by an adequate therapeutical scheme. We would like to report our experience treating this pathology.
Patients and method: Twelve patients (7 males and 5 females, aged between 14 and 75 years-old) were refered to our unit of Maxillofacial Surgery in a 4 years period (20062009) for unique laterocervical masses without any other clinical or paraclinical findings. Cervical scan was used to describe tumoral size and rapports. Nine of the twelve tumors were on the left side of the neck. Sizes was between 612 cm measured on their long axis. Four masses had liquid content, the other 8 being solid. All of the tumors were surgically removed by the same surgeon.
Results: Post operative evolution was without complication. Morpholgy diagnosed 4 lymph node metastasis of squamous cell carcinoma, 3 tuberculous adenopathies (scrofula), 2 lymph node metastasis of thyroid papillary carcinoma, 2 branchial cysts, and 1 hemangioma. Surgical treatment was differently completed, function of thee etiology: radiotherapy and chemotherapy (for squamous cell carcinoma), antituberculous medication, total thyroidectomy followed by radioiodine therapy and hormonal substitution therapy (for thyroid carcinoma). No further treatment was necessary for the cystic masses and hemangioma.
Conclusions: In our experience, most of the non-thyroidal laterocervical masses are malignant lymphadenopathies. Treatment could not be established until after surgery followed by morphology. Unique tumor masses have a high pathological variety and treatment strategy involves a multidisciplinary team.