case_images: PMC5787655_01
case_images: Coronal CT scan, demonstrating cystic lesion over the left side of the neck.
case_images: ijo-30-049-g001.jpg
case_images: PMC5787655_01_ijo-30-049-g001.jpg
case_images: F1
case_images: Flexible nasopharyngolaryngoscopy revealed slight fullness and medialization of the left pyriform fossa, with the epiglottis displaced to the right side.A computed tomography (CT) scan of the neck (Fig. 1) showed a cystic lesion over the left side of the neck, extending from the hyoid bone superiorly to the inferior border of the thyroid cartilage.
case_images: Multiplanar (coronal, sagittal and axial) and MIP images on CT and PET/CT (upper row) and on PET (lower row) demonstrating a subtle enlarged left thyroid lobe from a heterogenous enhancing lesion seen on CT. The lesion corresponds with high 18F-FDG intensity uptake
case_images: ijo-30-049-g002.jpg
case_images: PMC5787655_01_ijo-30-049-g002.jpg
case_images: F2
case_images: An 18F-FDG-PET CT scan (Fig. 2) demonstrated a large focus of a high-intensity 18F-FDG uptake in the left thyroid lobe.
case_images: PMC5787655_02
case_images: Axial CT scan of the neck at the level of hyoid bone demonstrating ill-defined low attenuation rounded lesions with thick wall in the anterior neck
case_images: ijo-30-049-g003.jpg
case_images: PMC5787655_02_ijo-30-049-g003.jpg
case_images: F3
case_images: A CT scan (Fig. 3) confirmed a midline cystic mass measuring 4.1 x 4.7 x 5 cm within the subcutaneous tissues and left strap muscles, but separated from a normal-looking thyroid gland.
case_images: PMC5787655_03
case_images: Axial CT scan of the neck demonstrating multiple cervical lymph nodes, with normal-looking thyroid gland.
case_images: ijo-30-049-g004.jpg
case_images: PMC5787655_03_ijo-30-049-g004.jpg
case_images: F4
case_images: A CT scan (Fig. 4) of the neck revealed multiple cervical lymphadenopathy bilaterally, with the largest measuring around 1.6 x 1.4 cm located at the right posterior cervical chain, which was enhancing the central necrosis.
case_images: Reconstructed integrated PET/CT of the neck in sagittal (right) and axial (left) plane. Images demonstrated a focus of high 18F FDG uptake in the right lobe of the thyroid gland
case_images: ijo-30-049-g005.jpg
case_images: PMC5787655_03_ijo-30-049-g005.jpg
case_images: F5
case_images: The investigation proceeded with an 18F-FDG-PET CT scan (Fig. 5), which showed an increased FDG uptake in the superior part of the right thyroid lobe and the right-sided neck lymph nodes at levels III and IV.