Lymphatic malformations are congenital vascular anomalies most commonly identified in infancy or early child-hood. Adult-onset presentations are rare and may be mistaken for neoplastic processes, making accurate diagnosis essential to avoid unnecessary intervention.
We report the case of a 20-year-old male who presented with a painless, soft mass on the left side of the neck, anterior to the sternocleidomastoid muscle and inferior to the mandible. Initial ultrasound revealed a 3.2 cm avas- cular, septated cystic structure. Follow-up contrast-enhanced CT demonstrated a 6.7 × 2.7 × 2.2 cm multiloculated cystic lesion adjacent to the left parotid tail with benign characteristics. MRI confirmed a T2-hyperintense lesion containing internal fat and minimal enhancement, favoring a diagnosis of lymphatic malformation versus benign cystic teratoma. A follow-up MRI months later revealed no interval growth or concerning features. Given the lesion’s stability and lack of symptoms, conservative management was elected.
This case demonstrates the value of multimodal imaging in the diagnosis and observation of adult-onset cervi- cal lymphatic malformations. It also highlights the importance of including this in the differential for adult neck masses.
We report the case of a 20-year-old male who presented with a painless, soft mass on the left side of the neck, anterior to the sternocleidomastoid muscle and inferior to the mandible. Initial ultrasound revealed a 3.2 cm avas- cular, septated cystic structure. Follow-up contrast-enhanced CT demonstrated a 6.7 × 2.7 × 2.2 cm multiloculated cystic lesion adjacent to the left parotid tail with benign characteristics. MRI confirmed a T2-hyperintense lesion containing internal fat and minimal enhancement, favoring a diagnosis of lymphatic malformation versus benign cystic teratoma. A follow-up MRI months later revealed no interval growth or concerning features. Given the lesion’s stability and lack of symptoms, conservative management was elected.
This case demonstrates the value of multimodal imaging in the diagnosis and observation of adult-onset cervi- cal lymphatic malformations. It also highlights the importance of including this in the differential for adult neck masses.