Case Study

Retropharyngeal soft tissue neoplasia in a 2 year old MN Bernese

This 2 year old MN Bernese presented with weight loss; neck mass on left side below larynx.

DX

Retropharyngeal soft tissue neoplasia with aggressive biological behavior.

Image Interpretation

Ultrasound of the neck –

A large ill-defined heterogenous, well-vascularized, soft tissue mass of > 5 cm diameter with multifocal mineralization and necrosis is seen dorsal and to both sides of the trachea. The mass is situated caudal to the larynx and mandibular salivary glands. One of the medial retropharyngeal lymph nodes is seen separate from the mass and presents mild symmetric enlargement. There is a significant centrifugal mass effect with esophageal displacement. The delineation of the esophageal surface is obscured which appears to be mainly due to the mass effect. Normal thyroid and parathyroid tissue is seen separate from the mass on the right and left side next to the common carotid artery.

Outcome

A lymphomatous origin/round cell neoplasia – such as histiocytic sarcoma,
lymphosarcoma – appears to be most likely. A carotid body tumor (apudoma) would
be a possible, but less likely neoplasia.Infiltrative growth is not overtly seen. Blind/Ultrasound guided fine needle aspiration is recommended for further definition.
CT would be ideal to ascertain the origin and extent of the lesion. Recommend to put
an esophageal probe during the CT.