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Cervical chyloma after neck dissection: a case report.

Masashi Kimura¹, Hiroyuki Ohto¹, Akio Shibata¹

¹Department of Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, Ogaki, Japan.

Nagoya Journal of Medical Science

|March 18, 2017

Summary

Cervical chylomas, rare pseudocystic collections, can occur after neck surgery. This case highlights a persistent chyloma in a patient with oral cancer, emphasizing the need for awareness and timely diagnosis.

Keywords:

cervical chyloma conservative therapy lymphocele thoracic duct

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Area of Science:

Head and Neck Surgery
Surgical Oncology
Radiology

Background:

Cervical chylomas are rare, non-epithelialized pseudocystic lymphatic fluid collections.
They typically arise secondary to thoracic duct injury from trauma or surgery.
Conservative and surgical treatments are available, but management can be challenging.

Observation:

A 64-year-old Japanese woman with gingival squamous cell carcinoma developed a left supraclavicular swelling post-mandibulectomy and neck dissection.
Ultrasound-guided fine-needle aspiration confirmed a chyloma, yielding milky fluid without malignant cells.
Despite conservative management (compressive dressing, low-fat diet), the chyloma persisted.

Findings:

The chyloma remained unchanged in size until the patient's death from metastatic disease five months post-surgery.
This case illustrates a post-operative cervical chyloma in the context of head and neck cancer surgery.
The diagnosis was confirmed via fine-needle aspiration cytology.

Implications:

Increased awareness of cervical chyloma as a potential post-operative complication is crucial for prompt diagnosis.
Early recognition aids in appropriate management, potentially improving patient outcomes.
This case underscores the importance of considering chyloma in the differential diagnosis of neck masses after surgery.