Unexpected Findings in the Head and Neck: When to Raise Concern for Possible Malignancy

Imaging of the head and neck is often challenging, given the complex anatomy and breadth of pathology. One particularly challenging scenario is when unexpected head and neck cancers are included on imaging examinations tailored to assess the brain, spine, chest, or vasculature. By detecting unexpected head and neck malignancies, radiologists can facilitate appropriate work-up, specialist referral, and timely treatment with the potential for improved patient outcomes. Through an anatomic site-based approach, this article highlights key imaging findings with which radiologists should be familiar to appropriately raise concern for and direct further work-up of possible head and neck malignancies.