Pharyngeal Pouch Co-existing with Thyroid Mass: A Rare Presentation

Area of Science:

• Otolaryngology
• Surgical pathology

Background:

• Pharyngeal pouches are rare outpouchings of the pharyngeal wall.
• They can present as neck masses, sometimes mimicking other conditions like thyroid masses.
• Diagnostic challenges arise due to their variable presentation and rarity.

Observation:

• A 60-year-old male presented with a 4-year history of a progressively enlarging neck mass.
• Initial assessment suggested a thyroid mass, but a second, doughy, reducible mass was noted in the upper neck.
• Investigations led to a preliminary diagnosis of a thyroid mass with an associated pharyngeal pouch.

Findings:

• Surgical exploration revealed the entire mass to be a pharyngeal pouch.
• The initial presentation and diagnostic workup were misleading.

Implications:

• This case underscores the need for comprehensive differential diagnosis in neck masses.
• It emphasizes the importance of considering pharyngeal pouches, even when thyroid pathology is suspected.
• Accurate diagnosis of pharyngeal pouches is crucial for appropriate management and to avoid unnecessary interventions.