Platysma Sign—A Clinical Manifestation of Infiltration of Platysma and the Subcutaneous Tissue by Large Neck Node

Abstract

AbstractWe propose a simple clinical sign that is seen in certain patients with bulky nodal metastases. The fundamental basis of this sign is the direct infiltration of platysma by the nodal mass causing contracture of the muscle fibers of platysma called “Platysma sign”. The exact definition of this sign is “ puckering of the platysma and the overlying skin like an inverted Japanese fan”. This puckering always happens below the level of nodes and finishes at the level of the clavicle. This clinical sign can serve as an instant reminder to the clinician and avoid oversight of the skin/platysma infiltration. Assessment of the integrity of the neck skin overlying a large neck nodes must be undertaken while examining a head and neck cancer patient with bulky neck metastasis. Infiltration of platysma or the skin is an important finding in the staging and treatment of the neck disease.