J Korean Soc Radiol.  2017 Apr;76(4):278-281. 10.3348/jksr.2017.76.4.278.

Enlarged Superior Cervical Sympathetic Ganglion Mimicking a Metastatic Lymph Node in the Retropharyngeal Space: A Case Report

• Kim JM
• Kim J
• Kim SH
• Choi EC

• KMID: 2373965
• DOI: http://doi.org/10.3348/jksr.2017.76.4.278

Abstract

The superior cervical sympathetic ganglion, the largest and most cranial of the three cervical sympathetic ganglia, transfers sympathetic signals to specific targets on the head and neck. This ganglion is located just lateral to the retropharyngeal space along the medial margin of the carotid sheath. Located thus, an enlarged superior cervical sympathetic ganglion can mimic a metastatic lymph node in the retropharyngeal space of the suprahyoid neck in head and neck cancer patients. However, this is often disregarded by radiologists due to lack of interest in its anatomic location. We present a case of an enlarged superior cervical sympathetic ganglion mimicking a retropharyngeal metastatic lymph node in a 42-year-old man with oral tongue cancer.

MeSH Terms

Adult
Ganglia, Sympathetic*
Ganglion Cysts
Head
Head and Neck Neoplasms
Humans
Lymph Nodes*
Neck
Superior Cervical Ganglion
Tongue Neoplasms

Figure

• 

  Fig. 1 A 42-year-old man with oral tongue cancer. A. Preoperative axial contrast-enhanced CT shows no visible abnormality in the left retropharyngeal area. B. An axial fat-saturated T2-weighted magnetic resonance (MR) image obtained 6 months after partial glossectomy and neck dissection reveals an enlarged mass of high signal intensity in the left retropharyngeal area (arrow) between the internal carotid artery and longus capitis muscle. C. Strong enhancement of the mass (arrow) and an internal poorly enhanced area at the center are observed on the axial contrast-enhanced fat-suppressed T1-weighted MR image. D. A coronal contrast-enhanced fat-suppressed T1-weighted MR image shows the elongated oval shape of the mass (arrows) in the longitudinal dimension. E. Histopathologic examination reveals a well-circumscribed mass with elongated shape containing many ganglion cells intermingled with nerve fibers, suggesting a ganglion. Many ectatic venules (arrows) are visible at the center of the ganglion (hematoxylin and eosin; × 40).

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