Cystic hygroma in adults: a single-centre experience and review of the literature.

Cystic hygroma (CH) is a benign congenital lymphatic malformation, occurring predominantly in children, typically as an asymptomatic neck mass. Surgical resection or sclerotherapy is the recommended treatment options. A retrospective review of four cases of adult-onset CH was performed over 2 years by a single surgeon across two institutions. Four patients (two females, median age 31.5 years) who presented with supraclavicular neck masses (range 5-17 cm) are discussed. Ultrasound and MRI demonstrated supraclavicular masses, suggestive of CH. All patients underwent surgical resection. Post-operative courses were uncomplicated, with a mean length of stay of 4 days. All histological samples returned as CH. As of yet, there are no guidelines on the management of CH. Individualised care tailored to each patient, following careful discussion is the most prudent approach. This study demonstrates that surgical resection is a safe and effective treatment for adults in this rarely encountered clinical entity.

A case of head and neck cancer metastasizing to the axillary lymph nodes.

Metastases of head and neck cancers to the axillary lymph nodes are rare. Our review of the literature found only five such reports involving 10 patients. We describe a new case that occurred in a 69-year-old man who presented with a 6-week history of right neck swelling. Positron-emission tomography/computed tomography demonstrated high F18-fluorodeoxyglucose uptake in the neck and also in the right axilla. Fine-needle aspiration cytology revealed squamous cell carcinoma (SCC) at both sites. The patient underwent right-sided radical neck dissection with pectoralis major myocutaneous flap reconstruction and axillary node block dissection. The patient was subsequently treated with chemoradiotherapy, but 6 months later he developed an SCC in the lung. The lung lesion was also treated with chemotherapy, but the patient died 5 months later. Our case is unique among similar cases in that our patient had not undergone any previous treatment of the neck primary. We discuss the mechanism of this unusual presentation.