Imaging Spectrum of Extrathyroidal Neck Masses

Extrathyroidal masses in the anterolateral neck are frequently encountered in the adult population and may represent a diagnostic dilemma. These neck masses can result from a diverse array of pathologies including congenital, inflammatory, infectious, and neoplastic causes. Relevant medical history and physical examination are essential to complement the imaging findings. Ultrasound (US) plays an important role in the initial evaluation of neck masses due to its reliability, availability, safety and cost-effectiveness. It can confirm or exclude the presence of a mass and initially characterize it as solid or cystic. Sonographically assessing the relationship of a mass to adjacent cervical anatomy can facilitate a more targeted differential diagnosis. US also effectively guides fine needle aspirations and/or biopsies of accessible lesions. Multimodality imaging is reserved for problem-solving complex cases and presurgical planning. The anterolateral neck masses are categorized into midline/paramedian lesions, salivary gland pathologies, and other soft tissue lesions. Midline and paramedian lesions include thyroglossal duct pathologies, ectopic thyroid tissue, and parathyroid adenomas. Salivary gland pathologies include obstructive/inflammatory processes, benign and malignant neoplasms, and systemic diseases. This pictorial essay presents clinical features and sonographic characteristics of extrathyroidal masses in the anterolateral neck with a brief discussion of other imaging modalities.