Pseudocyst in Neck: A Case Report on Rare Complication of Ventriculoperitoneal Shunt

Introduction. Ventriculoperitoneal shunt is a common neurosurgical procedure, for the definitive management of hydrocephalus. Shunt failures may occur due to various causes but are usually due to infections in adults and catheter occlusion in the paediatric population. Case Report. The 13-year-old girl presented with a right lateral neck swelling. In detailed history, she was found to be an old case of ventriculoperitoneal shunt. The clinical examination and radiological investigation revealed proximal dislodgment of the stent from the cranium, causing persistent cerebrospinal fluid (CSF) leak and pseudocyst formation in the neck. Conclusion. The case highlights CSF pseudocyst formation as a rare differential for lateral neck swellings.

Diagnostic Dilemma in a Carotid Body Tumor: A Case Report

An asymptomatic swelling in the neck region has many differential diagnoses. Most common of them is reactive lymphadenitis and carotid body tumor being the last thing. We present here a case of carotid body tumor that misguided us on clinical and radiological ground. It was suspected intra-operatively and confirmed by histopathological examination. Carotid body tumors are rare neoplasm. It arises from the chemoreceptor cells of the carotid bulb. We report a case of carotid body tumor in a 57-year-old female, who presented with painless, gradually progressive lateral neck swelling. The diagnosis is suspected on the basis of clinical radiological and per-operative examination findings. Histopathological examination confirms the diagnosis of carotid body tumor

Unusual Development of Second Branchial Cleft Cyst in an Adult after URTI: Diagnosis and Detailed Approach

Branchial cleft cyst is a congenital anomaly benign in nature. It usually appears in the lateral aspect of the neck and typically presents as a unilateral fluctuant mass. We present here a 30 years old adult who is previously healthy complaining of five years history of a left lateral neck swelling following an upper respiratory tract infection. Multiple aspirations were done but all resulted in recurrence of condition. Investigations have been done and a CT neck performed which showed a complicated second branchial cleft cyst. The definite treatment for branchial cleft cysts is surgery. He underwent surgical excision of the cyst with minimal scarring. This case is important due to the limited literature done in adults with branchial cleft cysts, in addition to highlighting the correct sequence of management when detecting a lateral cervical swelling.

Cervical thymic cyst in adult: a rare entity

<p>Cervical thymic cysts in adults are rare and seldom diagnosed preoperatively as it may mimic other cystic cervical swellings like a branchial cleft cyst. We present our first encounter with an adult-onset cervical thymic cyst presenting as a lateral neck mass as the sole symptom. Clinical, radiological and cytological evaluations are excellent tools to approach and assess cervical thymic cysts. Histopatholgical examination is the only mean to provide a definitive diagnosis. Adult-onset cervical thymic cyst is a rare entity but should be included in the differential diagnosis for lateral neck swelling. Surgical excision is both diagnostic and therapeutic, once malignancy has been exluded.</p>

An unexpected finding from a submental mass

This case describes a fit and well 17-year-old male who underwent surgical resection of a longstanding, painless, right lateral neck swelling. Believed to be either a vascular malformation, ranula or enlarged sublingual gland from pre-operative MR studies, histopathological examination of the mass revealed it as normal thyroid tissue. Post-operative imaging confirmed the absence of any remaining thyroid tissue. Hypothyroidism was confirmed with subsequent thyroid function tests. Interestingly, a “thyroid storm” which presented unknowingly during the surgical removal of the lesion did not trigger suspicion that thyroid tissue was being handled at the time. Normal, ectopic thyroid tissue in the lateral neck is rare but should be considered a differential diagnosis for neck lumps, particularly if it also presents as an intraoral swelling, as in this case. The presence of the orthotopic thyroid gland should be confirmed with diagnostic imaging prior to surgical excision of unknown neck masse

Presentation of Branchial Cleft Anomalies: Case Reports and Review of Literature

Type 2 branchial cleft anomalies are the most common cause of lateral neck swelling. We report two cases of type 2 branchial cleft anomalies. The first case is branchial cleft cyst and the second one is branchial fistula. Both cases were managed surgically. The post operative outcomes were uneventful. Second branchial cleft anomalies are the most common branchial anomalies. Branchial cysts are more common than sinuses and branchial fistulae are extremely rare. There is no gender predilection. The location, clinical symptoms and imaging findings aid in the diagnosis of this condition. Surgical excision is the mainstay of treatment.Keywords: branchial cleft; branchial cyst; branchial fistula.

Venous Malformation in the Neck

Introduction Venous malformation is a benign vascular lesion. Approximately 40% of such cases occur in head and neck. Case Report Venous malformation in a 19 year old man is reported, which presented as a lateral neck swelling. Discussion The venous malformation in the head and neck region may confuse the surgeon in distinguishing it from its other common congeners e.g. hemangioma, lymphangioma etc. and may also cause dilemma regarding its treatment modality. Treatment options include surgery, laser therapy, sclerotherapy or a combination depending upon the complexity of the lesion.

Rare cervical nerve root C2-C3 schwannoma

<p class="abstract"><span lang="EN-IN">10% of schwannomas that occur in the head and neck region mostly originate from the vagus or sympathetic nervous system whereas those arising from C2 nerve root are extremely rare. Extracranial schwannomas in the head and neck region are rare neoplasms. Diagnosis is established by imaging studies such as magnetic resonance imaging or computed tomography, while FNAC is used to rule out other condition. Histopathology gives definitive diagnosis. The accepted treatment for these tumors is surgical resection with preservation of the neural pathway. We present a rare case of cervical nerve (C2-C3) root schwannoma of 50 year old male who presented with right lateral neck swelling with pain radiating to right shoulder associated with right shoulder stiffness</span>. The swelling which also had an intervertebral part <span lang="EN-IN">was removed successfully through a posterior neck incision with no post-operative neurological symptoms.</span></p>

Parapharyngeal space schwannomas: our experience and review of literature

<p class="abstract"><strong>Background:</strong> Tumors of the parapharyngeal space are a rare group of head &amp; neck tumors. Due to their indolent nature they present late with either cranial nerve palsy or lateral neck swelling. The aim of the study was i) to determine the incidence of parapharyngeal space schwannoma among defence personnel’s and their dependents presenting to ENT OPD and ii) to study the clinical presentation, management and outcomes of such lesion.</p><p class="abstract"><strong>Methods:</strong> The study is a retrospective observational study. All new patients referred to ENT OPD at our center were included in the study. Data was collected from our OPD records over two years between Jan 2015 and Dec 2016. </p><p class="abstract"><strong>Results:</strong> It was found that the incidence rate of parapharyngeal space schwannoma was 0.034% out of all fresh cases reporting to ENT OPD and 0.47% out of all fresh diagnosed cases of head and neck tumours at our centre. Out of the total 5 cases of parapharyngeal space schwannomas, 2 patients had vagal schwannomas and one each had hypoglossal nerve schwannoma, spinal accessory nerve schwannoma and sympathetic chain schwannoma.</p><p><strong>Conclusions:</strong> Schwannomas of the parapharyngeal region can be very extensive and may require to be removed in a staged procedure involving the head &amp; neck and neurosurgeons.It is important to distinguish these tumors from other head and neck malignancies by detail clinical and radiological examinations. Despite the benign nature of the disease, the surgery can be morbid with cranial nerve palsies in extensive tumors. </p>