Clinical Images
Pulsatile Mass in the Neck
Mohammad R. Afrasiabi, Priya Radhakrishnan, M.D, Anna Boron, M.D, Priya Puri
A 79-year-old female with past medical history of multi-nodular goiter, osteoarthritis, vitamin D deficiency and hyperlipidemia presented to her primary care physician for evaluation of her multi-nodular goiter. Examination revealed the a mass (click on the link to open the video in a new window) along the medial border of patient’s right sternocleidomastoid muscle.
The mass was pulsatile, warm to touch, non-tender, non-pruritic and appeared to be fluid-filled. Auscultation of mass revealed no audible bruits. The mass did not move with swallowing.
The patient was not aware of its presence. She denied any nausea, vomiting, diarrhea, constipation, headache, dizziness, lightheadedness, change-in-vision, shortness-of-breath, chest pain, numbness, tingling or weakness.
Answer
References
Mirjalili, S. Ali, Sarah L. Mcfadden, Tim Buckenham, and Mark D. Stringer. "Vertebral Levels of Key Landmarks in the Neck." Clinical Anatomy 25.7 (2012): 851-57.
Countee, R. W., T. Vijayanathan, and C. Barrese. "Cervical Carotid Aneurysm Presenting as Recurrent Cerebral Ischemia with Head Turning." Stroke 10.2 (1979): 144-47.
Brief Biographies of Authors:
Mohammad R. Afrasiabi is a third-year medical student at the Creighton University School of Medicine.
Priya Radhakrishnan, M.D. is a practicing Internist and the Robert Craig Academic Chair of Internal Medicine at St. Joseph’s Hospital in Phoenix, Arizona.
Anna Boron, M.D. is a practicing Endocrinologist at St. Joseph’s Hospital in Phoenix, Arizona.
Priya Puri is a pre-medical student at the University of Pennsylvania.