Evaluation of primary lateral neck mass in adults: Cross sectional study

Yıl 2020, Cilt: 4 Sayı: 10, 891 - 897, 01.10.2020

Andres Constantino Limardo , Luis Blanco Jose Menendez Adrian Ortega

https://doi.org/10.28982/josam.703630

Öz

Aim: Primary Lateral neck mass (PLNM) is a disease that expresses a pathology in neck, excluding thyroid and skin tumors. The spectrum ranges from “lumps, mass or tumors,” congenital tumors, inflammatory diseases, and benign neoplasm to malignant neoplasm. The current Skandalakis algorithm excludes thyroid pathology. Correct anamnesis and physical examination are especially important for data collection. We herein analyzed the methods of study in PLNM.
Methods: This cross-sectional study was performed with review of medical records from January 2010 to July 2019. All patients with diagnoses of PLMN and older than 15 years of age were analyzed. We excluded patients with “classic” and unknown lateral neck masses. Standardized protocols for data collection were implemented to minimize or avoid bias. The statistical analysis was carried out with STATA v 14.0.
Results: A total of 78 patients were studied. Age and time of evolution were the most crucial factors in presumptive diagnoses. The most frequent location was the anterior triangle in the neck (77%). Murmurs and thrills were clinically defined as vascular pathologies. Mobility on all axes without fixation to deep planes were clinically defined as Lipoma. The pathological examinations were more frequently reported as lymphomas (32), which were followed by Branchial Cleft Cysts. Ultrasound was a complementary study useful in congenital malformations to determine cystic characteristics. The presence of “B symptoms” and FNA (fine needle aspiration) are useful in primary Lymphoproliferative adenopathy. MRI (Magnetic resonance image) and Angio-MRI are useful in tumors of nervous origin (schwannomas, neurofibromas, and paragangliomas tumors). Malignant soft tissue tumors (sarcomas) need complementary studies and imaging for surgical planning.
Conclusion: Differential diagnoses of the primary lateral neck masses challenge surgeons. Anamnesis and physical examination are the most crucial factors for the presumptive diagnoses. Complementary studies and imaging should be requested with selective criteria.

Anahtar Kelimeler

primary lateral neck mass, lateral neck mass, head and neck tumors

Erişkinlerde primer lateral boyun kitle değerlendirilmesi: Kesitsel çalışma

Öz

Amaç: Primer Lateral boyun kitlesi (PLNM), tiroid ve deri tümörleri dışında boyundaki patolojileri ifade eden bir hastalıktır. Spektrum “topaklar, kitle veya tümörler”, konjenital tümörler, enflamatuar hastalıklar ve iyi huylu neoplazmadan kötü huylu neoplazmaya kadar değişir. Mevcut Skandalakis algoritması tiroid patolojisini dışlamaktadır. Veri toplama için doğru anamnez ve fiziksel muayene özellikle önemlidir. Burada PLNM'de çalışma yöntemlerini analiz ettik.
Yöntemler: Bu kesitsel çalışma, Ocak 2010'dan Temmuz 2019'a kadar tıbbi kayıtların gözden geçirilmesi ile gerçekleştirildi. PLMN tanısı olan ve 15 yaşından büyük tüm hastalar analiz edildi. “Klasik” ve bilinmeyen lateral boyun kitlesi olan hastaları dışladık. Önyargıyı en aza indirmek veya önlemek için veri toplama için standartlaştırılmış protokoller uygulandı. İstatistiksel analiz STATA v 14.0 ile gerçekleştirildi.
Bulgular: Toplam 78 hasta incelendi. Yaş ve süregelme zamanı, varsayımsal tanılarda en önemli faktörlerdi. En sık yerleşim yeri boyundaki ön üçgendi (% 77). Üfürüm ve thrill, klinik olarak vasküler patolojiler olarak tanımlandı. Derin planlara fiksasyon olmaksızın tüm eksenlerde hareketlilik klinik olarak Lipoma olarak tanımlandı. Patolojik incelemeler daha sık lenfoma (32) olarak bildirilmiş, bunu Branşiyal Yarık Kistleri izlemiştir. Ultrason, kistik özelliklerin belirlenmesinde konjenital malformasyonlarda yararlı tamamlayıcı bir çalışmaydı. “B semptomları” ve FNA'nın (ince iğne aspirasyonu) varlığı, birincil Lenfoproliferatif adenopatide faydalıdır. MRI (Manyetik rezonans görüntüsü) ve Anjiyo-MRI, sinir kaynaklı tümörlerde (schwannomlar, nörofibromlar ve paraganglioma tümörleri) faydalıdır. Kötü huylu yumuşak doku tümörleri (sarkomlar), cerrahi planlama için tamamlayıcı çalışmalara ve görüntülemeye ihtiyaç duyar.
Sonuç: Primer lateral boyun kitlelerinin ayırıcı tanısı cerrahları zorlamaktadır. Anamnez ve fizik muayene, olası tanılar için en önemli faktörlerdir. Seçici kriterler ile tamamlayıcı çalışmalar ve görüntüleme talep edilmelidir.

Anahtar Kelimeler

Primer lateral boyun kitlesi, Lateral boyun kitlesi, Baş ve boyun tümörleri

Kaynakça

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