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Zenker's diverticulum misinterpreted as a thyroid mass: Case report
Fatemeh Salimi1, Jerocin Vishani Loyala1, Arbaaz Pervaiz1
1Oxford University Hospitals, NHS Foundation Trust, United Kingdom.
Annals of Medicine and Surgery (2012)
|December 9, 2020
Summary
Zenker's Diverticulum can present as a neck mass, sometimes mistaken for thyroid issues. Early CT scans are recommended for suspected pharyngeal pouch to prevent complications like mediastinitis.
Area of Science:
- Gastroenterology
- Otolaryngology
- Diagnostic Imaging
Background:
- Zenker's Diverticulum (ZD) is a rare condition involving an outpouching in the pharynx.
- Typical symptoms include dysphagia and regurgitation, but presentations can vary.
- Neck masses are an uncommon initial sign of ZD.
Observation:
- A 76-year-old male presented with a left-sided neck mass.
- Initial diagnosis considered a thyroid mass due to location and size.
- Ultrasound and fine-needle aspiration cytology were inconclusive.
Findings:
- A CT scan revealed a large pharyngeal pouch, diagnosing Zenker's Diverticulum.
- The patient's presentation mimicked other neck pathologies, leading to initial misdiagnosis.
- Inconclusive initial diagnostic tests complicated the case.
Implications:
- Recommends early CT scans for suspected pharyngeal pouch, especially with inconclusive cytology.
- Highlights the importance of considering ZD in atypical neck mass presentations.
- Early diagnosis via CT can prevent severe complications such as pouch perforation and mediastinitis.
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