An Enlarging Right Neck Mass in a 25-Year-Old Woman

An Enlarging Right Neck Mass in a 25-Year-Old Woman:






Kevin J. Doré, BS1; Prashanthi Divakar, MD2; Konstantinos Linos, MD3

Author Affiliations

1Geisel School of Medicine at Dartmouth, Hanover, New Hampshire

2Section of Otolaryngology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire

3Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire

JAMA Otolaryngol Head Neck Surg. Published online December 19, 2019. doi:https://doi.org/10.1001/jamaoto.2019.3842



A 25-year-old woman presented with a 6-month history of an enlarging right neck mass. The patient had a history of polycystic ovarian syndrome with insulin resistance and a migraine disorder and reported experiencing 1 to 2 migraine episodes per week since early high school. She believed that the neck mass made these episodes worse than normal. The patient was otherwise previously healthy until she developed an upper respiratory infection. Her physician noted visible swelling in the right neck and clinically interpreted the finding as enlarged lymph nodes associated with the infection. After 2 weeks, the neck swelling persisted despite the resolution of other symptoms. She was subsequently treated with a course of antibiotics, which did not result in any improvement. The mass slowly enlarged over the next 6 months. The patient reported new symptoms, including waxing and waning pain that radiated to the back of her neck, headaches, and intermittent dysphagia. She also noted periods during which the mass would fluctuate in size.