A 22-year-old woman presenting with swelling in the left side of the neck. Ax , axial; Cor , coronal CT, computed tomography.

A 61-year-old man with squamous cell carcinoma of the oral tongue and lung cancer. Ax , axial; Cor , coronal; CT, computed tomography; Sag , sagittal.

A 56-year-old woman with multiple masses in the neck. Ax , axial; Cor , coronal; CT, computed tomography; PET, positron emission tomography; Sag , sagittal.

A 35-year-old man from Cambodia presenting with a mass in the right side of the neck. Ax , axial; CT, computed tomography.

A 54-year-old woman with multiple lymphatic malformations. Ax , axial; Cor , coronal; FS, fat saturated; STIR, short T1 inversion recovery.


Scans from five different patients with cystic lesions along the lateral aspect of the neck are presented.

  • Case A features a rim-enhancing, homogeneous, low-attenuation cystic lesion in the left side of the neck between the submandibular gland and the left sternocleidomastoid muscle that is displacing the left common carotid artery bifurcation medially and abutting the parotid gland laterally and superiorly.

  • Case B features a thick, peripherally enhancing mass with central low attenuation in the left side of the neck at level II-III that is elevating the sternocleidomastoid muscle, abutting the left common carotid artery anteromedially, and narrowing the left internal jugular vein. A ring-enhancing right temporal lobe and insular lesion also is present.

  • Case C features conglomerate masses with central hypodensity bilaterally within the internal jugular chain and posterior triangle regions. Positron emission tomography demonstrates hypermetabolism with intense fluorodeoxyglucose uptake within the conglomerate masses and within the right tongue base. CT approximately 1 year later demonstrates a persistent cystic mass with decreased surrounding soft tissue.

  • Case D features a large, centrally hypodense mass in the right side of the neck involving the right sternocleidomastoid muscle, just inferior to the parotid gland. Multiple enlarged right jugulodigastric nodes are present. Narrowing of the right internal jugular vein is observed medially.

  • Case E features an extensive, well-marginated, multiseptated, T2-hyperintense, trans-spatial mass insinuating among structures of the left neck deep soft tissues and involving the left carotid space, left submandibular region, and deep left parotid region. Enhancement is present along the rim of the lesion and within some internal septations.


Case A

Second branchial cleft cyst (a cystic nodal metastasis cannot be excluded)

Case B

Necrotic left cervical lymph node and brain metastases from squamous cell carcinoma of the oral tongue or lung carcinoma

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