1.Beijing Friendship Hospital,Capital Medical University;2.Department of Otolaryngology Head and Neck Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing
Objective : Solitary cystic masses of the lateral neck in adults may cause difficulties in diagnosis. Malignancy must be ruled out since cervical lymphatic metastases arising from head and neck cancers may mimic the presentation of benign cystic masses, especially when the primary lesion is unknown. The purpose of this paper is to retrospective analyze the clinicopathological data of adult patients with initially diagnosed as benign cervical cysts in the ENT department of Beijing Friendship Hospital, explore the differential diagnosis points between benign and malignant masses, improve the accuracy of preoperative diagnosis. Methods:Retrospective review of the clinical, radiological and pathological records of all adult patients between 1/2014–12/2021 in ENT department of Beijing Friendship Hospital,the initial clinical diagnosis was branchial cleft cysts or cystic hygroma. Result: 37 patients were diagnosed as cervical benign cysts ,the overall rate of malignancy was 13.5 % ( 5 / 37 ): Cervial lymphatic metastases from oropharyngeal squamous cell carcinoma in two patients , from papillary thyroid carcinoma in two patients. The presence of septa and uneven thickening of cystic wall in the cervical masses was an independent predictor of malignant metastatic lymph nodes in solitary cystic masses of the lateral neck in adults (P=0.003,0.005). Conclusion: Solitary cystic masses of the lateral neck in adults need to be vigilant for unknown primary cervical carcinoma. For adults with solitary cystic masses in the lateral neck, especially for those with septa and uneven thickening of cystic wall in the cervical masses, multiple diagnostic methods should be combined to exclude unknown primary cervical carcinoma.