Int J Thyroidol.  2020 May;13(1):51-54. 10.11106/ijt.2020.13.1.51.

A High-Riding Subclavian Artery in the Anterior Neck Masquerading as Thyroid Tumor

Affiliations
  • 1Department of Otorhinolaryngology, College of Medicine, Gyeongsang National University, Gyeongsang National University Hospital, Jinju, Korea
  • 2Department of Institute of Health Sciences, College of Medicine, Gyeongsang National University, Gyeongsang National University Hospital, Jinju, Korea

Abstract

Anterior neck mass is a common symptom that is seen in otolaryngology surgery centers. Common types include thyroid tumor and thyroglossal duct cyst. In an elderly patient, a differentiated thyroid carcinoma should be suspected especially if it moves when swallowing. We encountered a typical presentation of a solitary thyroid nodule-like mass without pulsation in an 81-year-old female. We presented a rare diagnosis of pulsatile anterior neck swelling in which a high-riding subclavian artery should be considered as a differential diagnosis. Ultrasonography, Doppler scan, and contrast CT scan revealed that the neck mass corresponds to the high-riding subclavian artery. Therefore, ultrasonography is essential to detect any vascular lesion prior to biopsy or fine needle aspiration cytology as to avoid catastrophic hemorrhage.

Keyword

Anterior neck mass; High riding subclavian artery; Pulsatile neck mass

Figure

  • Fig. 1 Neck physical examination image. Right anterior neck swelling. (A) Anterior view. (B) Lateral view.

  • Fig. 2 The neck computed tomography images. The right innominate artery is normal anatomy. (A) The right subclavian artery is located below thyroid above clavicle. Arrow: Right innominate artery. (B) Axial view. (C) Coronal view. Arrow: Right high-riding subclavian artery.

  • Fig. 3 Neck Doppler ultrasound image. Right high-riding subclavian artery above clavicle.


Reference

1. Nugent A, El-Deiry M. Flint PW, Haughey BH, Lund V, Niparko JK, Robbins KT, Thomas JR, editors. 2015. Differential diagnosis of neck masses. Cummings otolaryngology - head and neck surgery. 6th ed. Elsevier Saunders;Philadelphia: p. 1767–72.
2. Ernemann U, Kramer U, Miller S, Bisdas S, Rebmann H, Breuninger H, et al. 2010; Current concepts in the classification, diagnosis and treatment of vascular anomalies. Eur J Radiol. 75(1):2–11. DOI: 10.1016/j.ejrad.2010.04.009. PMID: 20466500.
Article
3. Lai SY, Mandel SJ, Weber RS. Flint PW, Haughey BH, Lund V, Niparko JK, Robbins KT, Thomas JR, editors. 2015. Management of thyroid neoplasms. Cummings otolaryngology - head and neck surgery. 6th ed. Elsevier Saunders;Philadelphia: p. 1901–28.
Article
4. Wong TW. 2006; Lesions one needs to yell out for diagnosis. Paediatr Respir Rev. 2(4):9–12.
5. Mohamad I, Khalid M, Abdul Karim A. 2014; A pulsating mass in the pre-auricular region. Malays Fam Physician. 9(1):35–6. PMID: 25606298. PMCID: PMC4265971.
6. Upadhyaya PK, Bertellotti R, Laeeq A, Sugimoto J. 2008; Beware of the aberrant innominate artery. Ann Thorac Surg. 85(2):653–4. DOI: 10.1016/j.athoracsur.2007.08.044. PMID: 18222291.
Article
7. Moubayed SP, Ayad T. 2014; High-riding innominate artery encountered during neck surgery. Otolaryngol Head Neck Surg. 151(5):888–9. DOI: 10.1177/0194599814543771. PMID: 25056601.
Article
8. Gil-Carcedo E, Gil-Carcedo LM, Vallejo LA, Herrero D. 2012; High-riding innominate artery in neck surgery. Acta Otorrinolaringol Esp. 63(5):396–8. DOI: 10.1016/j.otorri.2011.03.006. PMID: 21570044.
Article
9. Wong BL, Gopalan S, Bakar MNA, Wong MH. 2017; High riding of brachiocephalic artery: A rare case of pulsatile anterior neck mass. EJENTAS. 18(3):291–3. DOI: 10.1016/j.ejenta.2017.07.006.
Article
10. Polyzos SA, Anastasilakis AD. 2009; Clinical complications following thyroid fine-needle biopsy: a systematic review. Clin Endocrinol (Oxf). 71(2):157–65. DOI: 10.1111/j.1365-2265.2009.03522.x. PMID: 19170717.
Article
11. Pramod S, Reddy R. 2018; Life threatening complication of fine needle aspiration of neck mass in a child: a case report. Int J Otorhinolaryngol Head Neck Surg. 4(3):860–2. DOI: 10.18203/issn.2454-5929.ijohns20181888.
Article
12. Anastasilakis AD, Polyzos SA, Nikolopoulos P. 2008; Subendothelial carotid hematoma after fine-needle aspiration biopsy of a solitary thyroid nodule. J Ultrasound Med. 27(10):1517–20. DOI: 10.7863/jum.2008.27.10.1517. PMID: 18809964.
Article
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