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78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2007, Munich

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Hygroma as a differential diagnosis of noninflammatoric swelling of the throat

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German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno071

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2007/07hno071.shtml

Published: August 8, 2007

© 2007 Kraemer et al.
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Case report 1: A 46-year-old female patient presented with a painless rounded swelling on the frontal border of the left sternomastoid muscle..There were no further complications in the history. The patient reported a suddenly increasing rounded swelling of the left throat after playing squash a day before. Clinical examination showed no signs of inflammation. Ultrasound and CT exams showed free fluid in the cervical fascia.The free fluid was found intraoperatively with no signs of abscess or bleeding. A CT of the chest was done. A big hygroma of entire mediastinum was found with its apex ending at the left clavicula. A spontaneous rupture of the hygroma was suggested as the propable origin of the fluid.The clinical follow up was unremarkable.A thoracic procedure was refused by patient,so follow up with an MRT of the chest after 3 months was done without change of the hygroma..

Case report 2: 75-year-old patient presented with a painless rounded swelling below and behind the angle of the jaw spreading until the right clavicula. As in case report 1 no signs of inflammation or abscess was present . A CT scan of the chest and neck described a large tumor.Cytological puncture concluded a benign tumor. Exstirpation of tumor showed a hygroma. Postoperative follow up was unremarkable.

Dicussion: The hygroma consists of ectopic endolymphatic cells with exprimation in childhood or youth . Hygroma is rarley described in the upper mediastinum. Hygroma and cysts should be considered as a differential diagnosis of inflammatory tumors of the neck wirh further examination of the upper mediastinum.

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References

1.
Karapantzos I, Mpouros M, Huber I. Das zervicale zystische Hygrom. HNO. 2004;50:1014-16.
2.
Obermann EC, Mayr C, Bonkowsky V, Büttner R. HNO. 1999;47(9):821-4.