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Oncology

Large Bilateral Compressible Neck Mass in 55-Year-Old Man

Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.

1 Credit CME

JAMA Otolaryngology–Head & Neck Surgery

Published Online: December 22, 2022

Clinical Challenge

Article Information and Disclosures

Sruti Tekumalla, BA¹;

Tom Thomas, MD, MPH²

Author Affiliations

¹Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, Pennsylvania
²Head and Neck Reconstructive Surgery at Morristown Memorial Hospital, Morristown, New Jersey

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A 55-year-old male jazz musician with a medical history that was significant for hypertension, coronary artery disease, and obstructive sleep apnea presented with an enlarging right more than left-sided neck mass of more than 2 years’ duration. The patient was seen and evaluated by a local surgical oncologist with a working diagnosis of possible lymphoma. The growing neck mass was causing solid food dysphagia and difficulty breathing at night. He did not have any neurological deficits. On further questioning, he had a similar mass that was treated with liposuction 10 years prior. His family history was negative for any head and neck benign or malignant disease. His social history was negative for tobacco or alcohol use. This patient was not taking any steroid medications.

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A 55-year-old male jazz musician with a medical history that was significant for hypertension, coronary artery disease, and obstructive sleep apnea presented with an enlarging right more than left-sided neck mass of more than 2 years’ duration. The patient was seen and evaluated by a local surgical oncologist with a working diagnosis of possible lymphoma. The growing neck mass was causing solid food dysphagia and difficulty breathing at night. He did not have any neurological deficits. On further questioning, he had a similar mass that was treated with liposuction 10 years prior. His family history was negative for any head and neck benign or malignant disease. His social history was negative for tobacco or alcohol use. This patient was not taking any steroid medications.

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Article Information

Corresponding Author: Tom Thomas, MD, MPH, Head and Neck Reconstructive Surgery, Morristown Medical Center, 100 Madison Ave, Morristown, NJ 07960 (tom.thomas@atlantichealth.org).

Published Online: December 22, 2022. doi:10.1001/jamaoto.2022.4237

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.