Document Detail

Lateral cervical cysts: an Australian perspective.
MedLine Citation:
PMID:  22924937     Owner:  NLM     Status:  Publisher    
BACKGROUND: Correctly identifying the aetiology of lateral cervical cysts poses a diagnostic challenge commonly encountered by head and neck surgeons. The aim of this study was to ascertain the effectiveness of current investigatory techniques used in the diagnosis of these masses. METHODS: A retrospective analysis of all patients presenting to a single Sydney Head and Neck Unit between 2000 and 2010 with the diagnosis of a lateral cervical cyst was performed. Patients with a clinically evident primary malignancy were excluded from the study. Results of their clinical assessment and any investigations performed were compared with pathology after surgical excision. RESULTS: Forty-seven patients met the inclusion criteria. Twelve of the 47 masses showed squamous cell carcinoma on histology post-operatively. The remainder of the masses (35 out of 47) were histologically diagnosed as branchial cleft cysts. Of the malignant tumours, 4 of 12 (33%) were correctly identified before cyst removal. Fine-needle aspiration (FNA) was performed in 37 of the 47 patients, with a sensitivity of 25% and a specificity of 96.6%. Notably, a false-positive result was obtained from FNA in a patient who had a final diagnosis of branchial cyst after modified radical neck dissection. The rate of malignancy in patients aged over 40 years (44%) was higher than that of the total group (25.5%) and significantly higher than that of patients aged below 40 years (0%). CONCLUSIONS: Current techniques in the investigation of cystic neck masses are suboptimal in their accuracy. Clinical evaluation and, in particular, thorough examination of the oropharynx directly and by fibre-optic nasendoscopy will often reveal the presence of a primary cancer when present. Care must always be taken in the evaluation of such lesions to maximize the likelihood of making the correct diagnosis.
David Veivers; James Dent
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-24
Journal Detail:
Title:  ANZ journal of surgery     Volume:  -     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.
Department of Otolaryngology Head and Neck Surgery, Royal North Shore Hospital, The University of Sydney, St. Leonards, New South Wales, Australia.
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