RESUMEN
A 38-year-old woman with anterior mediastinal Hodgkin lymphoma underwent F-FDG PET/CT, revealing abnormal uptake at the left retrostyloid parapharyngeal space. After chemotherapy, follow-up PET/CT showed regression of previously avid lesions but not the left retropharyngeal mass. Subsequent MRI revealed findings suggestive of neurogenic tumor. Transoral biopsy revealed ganglioneuroma, which is uncommon in the parapharyngeal space, although usually of benign nature. This case therefore highlights the importance of PET/CT in both initial diagnostic screening for tumor development and posttreatment evaluation of ambiguous lesions.
Asunto(s)
Ganglioneuroma/diagnóstico por imagen , Enfermedad de Hodgkin/complicaciones , Neoplasias Faríngeas/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Adulto , Femenino , Fluorodesoxiglucosa F18 , Ganglioneuroma/complicaciones , Humanos , Neoplasias Faríngeas/complicaciones , RadiofármacosRESUMEN
RATIONALE: Xanthogranulomatous inflammation (XGI) is a rare inflammatory process, which mostly affects the kidney and gallbladder. It usually simulates an aggressive neoplastic process. Occurrences in the neck are extremely rare and would usually be associated with a preexisting cyst or glandular tissues. PATIENT CONCERNS: A 49-year-old diabetic patient presented with a right painful neck mass for a week. The pretreatment computed tomography (CT) imaging with contrast demonstrated a huge ill-defined heterogeneous-enhanced lesion abutting surrounding musculatures and great vessels. Both fine needle aspiration (FNA) and ultrasound-guided core biopsy of the neck mass showed inflammatory cells only. DIAGNOSES: Histologic evaluation found granulation tissue with histiocytes and occasional Touton giant cells confirming the diagnosis of xanthogranuloma. INTERVENTIONS: Open excisional biopsy demonstrated a yellowish mass-like lesion with abscess inside. OUTCOMES: The patient recovered from the disease without posttreatment comorbidities. LESSONS: This case highlights the need for physicians to maintain awareness of this clinical entity and delayed- or overtreatment should be avoided in these patients due to preoperative ambiguous diagnosis.