Clinicopathological Evaluation of Supraclavicular Fossa Masses: A Retrospective Study of 108 Patients

Abstract

Objective: Supraclavicular fossa masses present a diagnostic challenge because of their location at a critical anatomical junction and their wide range of different aetiologies. There are currently few studies in the literature that particularly address supraclavicular fossa masses, despite the region's clinical relevance. This study aims to analyse patients who presented to our clinic with a mass in the supraclavicular fossa and were diagnosed via open biopsy.

Material and Methods: The medical records of patients who underwent excisional or incisional biopsy for supraclavicular fossa masses in our clinic and were subsequently diagnosed through histopathological examination were retrospectively reviewed. The findings were analysed and discussed.

Results: A total of 108 patients were included in the study, comprising 58 males (53.7%) and 50 females (46.3%), with a mean age of 52.7 years (range: 12-86). Biopsies were performed on the left supraclavicular fossa in 65 patients (60.1%) and on the right in 43 patients (39.9%). Malignant metastases were detected in 54.8% of incisional biopsies and in 23.3% of excisional biopsies. The incidence of malignancy was 65.8% in patients over 40 years of age, compared to 88% in those aged 18–40 years. Malignant pathologies were more common in males (75.9%) than in females (64%). Malignancy was identified in approximately two-thirds of the biopsies from both sides. Histopathological analysis revealed malignant lymphoproliferative disease in 41 patients (37.9%), malignant metastases in 35 (32.4%), inflammatory/reactive processes in 28 (25.9%), and benign mesenchymal neoplasms in 4 (3.7%).

Conclusion: Supraclavicular fossa masses encompass a broad differential diagnosis. Clinicians should maintain a high index of suspicion for malignancy, particularly among adult patients.

Keywords

• Supraclavicular fossa
• neck neoplasms
• differential diagnosis
• biopsy
• histopathology

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