Supraclavicular Neck Mass Research Articles

The Role of Immunotherapy and Radiation Therapy in Tumor Chemosensitivity in Advanced Head and Neck Cancer

Patient: Male, 56Final Diagnosis: Advanced stage squamous cell carcinoma of the head and neckSymptoms: Rapidly enlarging mass in left neckMedication: —Clinical Procedure: —Specialty: OncologyObjective:Unusual clinical courseBackground:Cancer is the second leading cause of death internationally, resulting in millions of deaths each year. While treatment in the past has heavily relied on surgery and radiotherapy, chemotherapy and immunotherapy are being increasingly utilized depending on disease presentation.Case Report:A 56-year-old male presented to the Emergency Department with a 3-week history of a rapidly enlarging left supraclavicular neck mass. Computed tomography scan revealed a 12×13 cm mass extending from the angle of the mandible to the supraclavicular area. A biopsy confirmed advanced stage squamous cell carcinoma of the head and neck. The patient was started on a chemotherapy regimen of docetaxel, cisplatin, and 5-fluorouracil (TCF). The tumor progressed through chemotherapy, which was switched to cetuximab; however, this therapy was discontinued after an anaphylactic reaction. Palliative radiation treatment was begun along with pembrolizumab. Pembrolizumab was continued, and after 9 cycles, the patient’s cancer was almost in complete remission. Three months later, disease progression was once again noted with pembrolizumab treatment, which was subsequently discontinued. The patient was started on paclitaxel and carboplatin chemotherapy regimen as a last resort, despite failure of prior TCF treatment, and the patient responded, this time with complete remission in 4 months.Conclusions:This case demonstrates a unique outcome in which a patient who previously was resistant to chemotherapy, later responded to chemotherapy after a trial of radiation therapy and immunotherapy. Immunotherapy may have a synergistic effect with radiation therapy and play a role in tumor sensitivity to chemotherapy in head and neck cancer treatment.

Supraclavicular Neck Mass as Sole Presenting Symptom for Seminoma in an Elderly Male

We report an unusual case of genitourinary malignancy in an otherwise asymptomatic elderly male, which was discovered via workup of a supraclavicular neck mass. We present his clinical workup as well as the pathological workup and how it influenced our decision-making. A review of the literature is also discussed and demonstrates how uncommon it is for seminomas to present in this manner.

Gossypiboma of the Neck Mimicking an Isolated Neck Recurrence

A gossypiboma (also called textiloma or retained surgical sponge) of the neck is rarely reported compared to intraabdominal or intrathoracic gossypibomas and also can be misdiagnosed as metastatic lymph nodes. A patient was referred to our clinic for a supraclavicular neck mass 6 months after thyroidectomy and neck dissection for papillary thyroid carcinoma in another hospital. It was initially considered an isolated neck recurrence, but it was finally diagnosed as gossypiboma by a pathological examination of the surgically-excised specimen. Characteristic findings of computed tomography or positron emission tomography/computed tomography might be helpful to differentiate the gossypiboma from malignant neck mass or other inflammatory conditions. It is essential for clinicians to be aware of this disease entity in differential diagnosis of neck recurrence because a gossypiboma in the neck can be misinterpreted as a malignancy to induce unwarranted radical surgery.

58 INVITED Late effects of long-term childhood cancer survival

Purpose: To show that a supraclavicular neck mass may be indicative of metastatic testicular carcinoma and to offer further insight into the treatment of residual neck disease.Method: We report six cases of testicular carcinoma metastatic to the neck. All were initially treated with radiation, chemotherapy, or a combination of both depending on histological type.Results: Neck masses persisted despite primary therapy. Three patients underwent subsequent modified neck dissection and remained free of disease; three others received nonsurgical forms of adjuvant therapy and ultimately died of their cancer.Conclusion: Metastatic testicular carcinoma may manifest as a supraclavicular neck mass and must therefore be considered in the differential diagnosis of a mass in this region. Surgical resection is indicated in the management of neck masses that persist after cytoreductive chemotherapy to remove residual foci of disease and potential source of spread.

Cervical mature teratoma 17 years after initial treatment of testicular teratocarcinoma: report of a late relapse

BackgroundLate relapses of testicular germ cell tumor are uncommon. We report a case of cervical mature teratoma appeared 17 years after treatment of testicular teratocarcinoma.Case presentationA 20- year- old patient underwent left sided orchiectomy followed by systemic therapy and retroperitoneal residual mass resection in 1989. He remained in complete remission for 200 months. In 2005 a huge left supraclavicular neck mass with extension to anterior mediastinum appeared. Radical surgical resection of the mass was performed and pathologic examination revealed mature teratoma.ConclusionThis is one of the longest long-term reported intervals of a mature teratoma after treatment of a testicular nonseminoma germ cell tumor. This case emphasizes the necessity for follow up of testicular cancer throughout the patient's life.

Testicular carcinoma metastatic to the neck

Purpose: To show that a supraclavicular neck mass may be indicative of metastatic testicular carcinoma and to offer further insight into the treatment of residual neck disease. Method: We report six cases of testicular carcinoma metastatic to the neck. All were initially treated with radiation, chemotherapy, or a combination of both depending on histological type. Results: Neck masses persisted despite primary therapy. Three patients underwent subsequent modified neck dissection and remained free of disease; three others received nonsurgical forms of adjuvant therapy and ultimately died of their cancer. Conclusion: Metastatic testicular carcinoma may manifest as a supraclavicular neck mass and must therefore be considered in the differential diagnosis of a mass in this region. Surgical resection is indicated in the management of neck masses that persist after cytoreductive chemotherapy to remove residual foci of disease and potential source of spread.

Aneurysm of the thoracic duct presenting as an asymptomatic left supraclavicular neck mass

Aneurysm of the thoracic duct presenting as an asymptomatic left supraclavicular neck mass

Modified Neck Dissection for Metastatic Testicular Carcinoma

Carcinoma of the testicle is a unique clinicopathologic entity in that an optimistic attitude toward cure can be entertained even in the presence of distant metastasis. Chemotherapy, followed by an aggressive surgical resection of residual disease, can result in eradication of this neoplasm. This tumor is capable of being monitored by the use of serum markers, namely, human chorionic gonadotropin and alpha-fetoprotein. After induction chemotherapy, the transition of elevated serum tumor markers to normal levels suggests that malignant disease has been eliminated or converted to teratoma. Elevated markers indicate persistent or recurrent carcinoma and mandate further chemotherapy. If normalization of tumor markers occurs, any residual mass in the abdomen, chest, or neck should be surgically resected. The otolaryngologist plays a role in the diagnosis and the resection of residual neck disease. Metastatic testicular carcinoma can present as a supraclavicular neck mass and must be considered in the differential diagnosis of a mass in this area. Large residual neck lesions are best removed through the exposure afforded by modified neck dissection.