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Imaging Spectrum of Extrathyroidal Neck Masses.

Naiya Patel1, Sean Gharai1, Kathleen A Brindle2

  • 1Department of Radiology, The George Washington University Hospital, Washington, DC.

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Extrathyroidal neck masses in adults present a diagnostic challenge. Ultrasound (US) is crucial for initial evaluation, characterizing masses, and guiding biopsies, aiding in differential diagnosis.

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Area of Science:

  • Radiology
  • Head and Neck Imaging
  • Diagnostic Ultrasound

Background:

  • Extrathyroidal masses in the anterolateral neck are common in adults, posing diagnostic challenges.
  • These masses stem from diverse causes, including congenital, inflammatory, infectious, and neoplastic conditions.
  • Clinical history and physical examination are vital adjuncts to imaging.

Purpose of the Study:

  • To present the clinical features and sonographic characteristics of extrathyroidal anterolateral neck masses.
  • To categorize these masses and discuss their differential diagnoses.
  • To highlight the role of ultrasound in their initial evaluation and management.

Main Methods:

  • Review of clinical features and imaging findings of extrathyroidal anterolateral neck masses.
  • Emphasis on ultrasound (US) as the primary imaging modality.
  • Discussion of mass categorization: midline/paramedian lesions, salivary gland pathologies, and other soft tissue lesions.
  • Brief mention of multimodality imaging for complex cases.

Main Results:

  • Ultrasound is reliable, available, safe, and cost-effective for initial neck mass assessment.
  • US can confirm mass presence, differentiate solid from cystic lesions, and assess anatomical relationships.
  • Sonographic findings guide fine needle aspiration and biopsy procedures.
  • Categorization aids in targeted differential diagnosis, including thyroglossal duct anomalies, ectopic thyroid, parathyroid adenomas, and salivary gland diseases.

Conclusions:

  • Ultrasound is the cornerstone for the initial evaluation of extrathyroidal anterolateral neck masses.
  • Sonographic assessment, combined with clinical information, facilitates accurate diagnosis and management planning.
  • Multimodality imaging is reserved for complex cases and presurgical planning.