Spontaneous right cervicothoracic lymphocoele

Podbielski, Francis J.; Rodríguez, Herón E.; Djohan, Risal; Connolly, Mark W.; Conlan, A. Alan

doi:10.1067/mtc.2003.55

Cited by 9 publications

(4 citation statements)

References 6 publications

(3 reference statements)

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“…These drain the right side of the head and right upper limb only. Lymph flow is therefore lower than on the left side, and lymphocoeles are correspondingly less frequent 4 …”

Section: Discussionmentioning

confidence: 90%

Spontaneous cervical lymphocoele: case reports and management decisions

2009

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“…These drain the right side of the head and right upper limb only. Lymph flow is therefore lower than on the left side, and lymphocoeles are correspondingly less frequent 4 …”

Section: Discussionmentioning

confidence: 90%

Spontaneous cervical lymphocoele: case reports and management decisions

2009

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“…Congenital weakness of the duct wall has been postulated as the reason for their formation in otherwise healthy individuals. 3 In one other reported case of a right-sided, spontaneous, cervical lymphocoele, 4 it was suggested that repeated movements acting upon a weakened duct wall lead to expansion into a cyst. In this case and in our first patient, the lesion arose after a non-contact exercise session at a fitness gym.…”

Section: Discussionmentioning

confidence: 99%

“…Lymph flow is therefore lower than on the left side, and lymphocoeles are correspondingly less frequent. 4 Traumatic lymphocoeles can be explained by weakening of the lymphatic duct wall, leading to expansion and cyst formation. Atraumatic lymphocoeles are more difficult to explain.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous cervical lymphocoele: case reports and management decisions – ERRATUM

Walker¹,

MacGregor²,

Ganley³

2010

J. Laryngol. Otol.

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“…The right drains the head, neck and upper limb so lymphatic flow is significantly lower. 3 Historically and in recent case series, complete surgical excision has been considered the treatment of choice for cervical lymphocoeles. However, for large extensive lymphocoeles there can be significant risk to vascular, neurological and pulmonary structures.…”

Section: Discussionmentioning

confidence: 99%

Cervical lymphocoele: a simple solution for a complicated problem

Qureishi

Silva

Lamyman

et al. 2012

annals

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Spontaneous cervical lymphocoeles are extremely rare. Their surgical management can pose many challenges with the lack of clear surgical planes potentiating risks. We present the case of a patient with an extensive right-sided cervical lymphocoele. Surgical excision would have involved extensive surgery with risk to the great vessels and lungs. We describe the successful use of talc sclerotherapy in the management of this patient, who made a rapid post-operative recovery with no evidence of recurrence on follow-up. Talc sclerotherapy may be used successfully in the management of patients with cervical lymphocoeles, obviating the need for high risk surgical procedures.Lymphocoeles are subcutaneous lymphatic accumulations lined by an endothelial sac. Primary spontaneous cervical lymphocoeles are extremely rare, the acquired variety occurring more frequently, usually in the context of a traumatic or iatrogenic aetiology.1 They are also predominantly left sided. The exact pathophysiology is elusive. However, there are suggestions that the spontaneous types are a result of congenital weakness.2 The clinical presentation is usually of a fluctuant, asymptomatic cystic swelling of the neck in otherwise healthy individuals. 2 We present the case of a patient with a large complicated spontaneous cervical lymphocoele treated with talc sclerotherapy. Case historyA 35-year-old man was referred to the ear, nose and throat (ENT) clinic with a 12-month history of a right-sided neck lump. There were no other upper aerodigestive tract symptoms. The patient was otherwise fit and well with no other co-morbidities.Examination revealed a large non-tender fluctuant right-sided neck mass in the right supraclavicular region extending below the clavicle (Fig 1). It was not possible to determine the lower extent of the mass. The rest of the ENT examination including the upper aerodigestive tract was normal.Fine needle aspiration revealed a straw coloured aspirate mainly consisting of mature lymphocytes, raising the suspicion of a lymphocoele. Gadolinium enhanced magnetic resonance imaging showed a large unilocular mass lesion, deep to the sternocleidomastoid and extending below the clavicle, inserted between the subclavian vessels without distorting them. The working diagnosis was that of a spontaneous cervical lymphocoele. Surgical excision would involve a combined ENT/cardiothoracic approach, with access to the lower end facilitated by disarticulating the clavicle from the sternum to aid safe dissection from the great vessels. This would carry the risk of significant morbidity. The alternative option would be sclerotherapy. Following a consensus discussion, the plan was to manage this case with sclerotherapy.

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Spontaneous right cervicothoracic lymphocoele

Cited by 9 publications

References 6 publications

Spontaneous cervical lymphocoele: case reports and management decisions

Spontaneous cervical lymphocoele: case reports and management decisions

Spontaneous cervical lymphocoele: case reports and management decisions – ERRATUM

Cervical lymphocoele: a simple solution for a complicated problem

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