Presentation
Presented for trouble breathing and a palpable cervical mass.
Patient Data
There is an oval mass dorsal to the trachea in the cranial neck. It extends from C2 to C5 and deviates the trachea ventrally. There is an irregular gas lucency through the mid-area of the mass, and the caudal aspect is also outlined by gas in the esophageal lumen.
On sagittal and transverse ultrasound images, the mass is homogeneous and hypoechoic. The esophageal lumen passes through the center of the mass. The mass is an expansion of the esophageal wall.
Esophageal mass.
Case Discussion
Extramedullary plasmacytoma (fine needle aspirate and immunohistochemistry). Differential diagnosis could include leiomyoma, granuloma, and epithelial neoplasia.
The position of the mass caudal to the pharynx and dorsal to the trachea make an esophageal mass most likely. In addition, the gas in the lumen and caudal to the mass support this location.
Ultrasound made a definitive diagnosis on the mass location. An esophagram would have also delineated the margins well.
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