Sudden Enlargement of the Neck

Abstract

A 63-year-old man presented with a sudden enlargement of his neck. During the previous 10 years, his neck had grown progressively larger until he was no longer able to button up his shirts or wear a necktie. A previous diagnosis of cystic hygroma had been made, and conservative management advised. The increase in swelling on the left side of his neck occurred suddenly while he was watching television. He felt faint on swallowing and began pooling saliva. On examination, his neck was swollen, soft, and nontender (Panel A). The swelling moved on swallowing. Computed tomography (Panel B) showed a large . . .