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We present an uncomplicated case report of a cervical thoracic duct cyst (CTDC) in a 61-yearold woman treated with surgical excision. We reviewed 47 similar cases since it was first described in 1964 and evaluated the different diagnostic and management approaches. Previously believed to be the gold standard tool for evaluation, lymphangiography is now less popular due to advent of high-resolution imaging combined with aspiration techniques. CTDC treatment includes observation, low-fat diet, repeated aspirations, external pressure, sclerotherapy, embolisation, and surgical intervention. The preferred management of choice to date is surgical excision.

Introduction: Recent studies have reported that elevated levels of platelets and inflammatory markers are associated with poor treatment outcomes among patients with solid tumours, but reports are conflicting in head and neck cancer (HNC) patients. Objective: To establish if pre-treatment anti-inflammatory markers can be used as a prognostic tool of overall survival and tumour control among HNC patients. Methods: We retrospectively reviewed the pre-treatment platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) of 147 HNC patients from 2014 to 2018 and analysed their association with tumour progression and overall treatment outcomes. The optimal cutoff was established at > 200 for high PLR and > 2.85 for high NLR. Results: After adjusting for age, disease stage, and treatment, patients with higher PLR had an almost 3 times higher risk of mortality during the study period than patients with normal PLR (hazard ratio [HR] 2.79, 95% confidence interval [CI] 1.43-5.47, p < 0.01). Furthermore, the patients with higher NLR had an > 2.5 times higher risk of mortality than those with normal NLR (HR 2.62, 95% CI 1.19-5.81, p = 0.02). Conclusion: This observational study shows that elevated PLR and NLR in HNC patients, who were treated with either surgery or primarily chemoradiotherapy, are associated with poor overall survival.

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Malignant carotid body paraganglioma can affect young adults, with an insidious onset of symptoms. In this patient, local excision (without neck dissection) and adjuvant radiotherapy were well tolerated and resulted in satisfactory local disease control.