Soft Tissue Neck Mass -- Tonsilar Carcinoma
Tonsilar CA
Findings:
- A large soft tissue mass is present in the right side
of the patient's neck.
- The trachea is deviated to the left.
- Ill-defined opacities are present in the left
mid and lower lung fields.
- No effusions are identified.
- No gross bone destruction is seen.
Discussion:
- Soft tissue mass in the neck is non-specific.
- Clinical history is important.
- The DDX includes:
- Abscess
- Hematoma
- Lymphadenopathy
- Vascular Masses
- Congenital Abnormalities
- Neoplasm
Radiographic findings are consistent with, but not specific for,
salivary gland tumor with metastic spread to lung.
You may wish to review some facts regarding Tonsilar Carcinoma:
- More frequent in older males.
- 2nd most common head and neck malignant tumor after CA
of larynx.
- Usually squamous cell.
- Smaller number are lymphoepitheliomas and
transitional cell CA's.
- Early local extension and lymph node mets common.
- Prognosis usually poor.
- CT used for staging.
Teaching Point:
- It is difficult to force oneself to look at soft tissues
and bones on chest radiographs.
- If one does neglect these areas, significant pathology
can be missed
Ref: Unger, June M. Handbook of Head and Neck Imaging, Churchill
Livingstone, New York, 1987. pp. 98 - 99.
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Tonsilar CA