Sternoclavicular joint hypertrophy following radical neck dissection

The classic radical neck dissection continues to dominate therapy for cervical metastasis. While the morbidity, complications, and sequelae of this procedure are well documented, sternoclavicular joint hypertrophy appears to have escaped attention. In order to establish the true incidence of this frequently noted but poorly documented condition, 50 randomly selected patients who had undergone radical neck dissection were evaluated retrospectively. Significant sternoclavicular hypertrophy was noted in 54% of the patients, but in only 4 (8%) was the condition severe enough to cause patient or physician concern. Surgical exploration was performed in 2 cases. The etiology of this condition is discussed, as are the radiologic findings, which may be suggestive of metastasis. The major clinical significance is an awareness of the condition and avoidance of over investigation and surgical exploration except in the most suspicious circumstances.