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Stratifying risk of malignancy in cystic lateral neck lumps: a multivariant analysis of demographic, radiological and histological investigation factors and the development of a patient-centred risk-predictive tool for malignancy

Published online by Cambridge University Press:  23 May 2023

Victoria Evans Open the ORCID record for Victoria Evans [Opens in a new window] ,
Eduard Prades ,
Carl Passant ,
David Owens  and
Andrew Harris
Victoria Evans*
Affiliation:
Department of Otolaryngology, Aneurin Bevan University Health Board, Newport, Wales, UK
Eduard Prades
Affiliation:
Department of Otolaryngology, Betsi Cadwaladr University Health Board, Rhyl, Wales, UK
Carl Passant
Affiliation:
Department of Otolaryngology, Aneurin Bevan University Health Board, Newport, Wales, UK
David Owens
Affiliation:
Department of Otolaryngology, Cardiff and Vale University Health Board, Cardiff, Wales, UK
Andrew Harris
Affiliation:
Department of Otolaryngology, Aneurin Bevan University Health Board, Newport, Wales, UK
*
Corresponding author: Victoria Evans; Email: [email protected]
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Abstract

Background

Management of lateral cystic neck masses with no apparent upper aerodigestive tract primary tumour in adults is controversial. Imaging modalities and fine needle aspiration cytology often struggle to distinguish the presence of malignancy.

Method

This study entailed a multicentre retrospective review of all patients with isolated lateral cystic neck masses from 2012 to 2018 in three Welsh health boards, utilising demographic data and first-line investigations (ultrasound scanning and fine needle aspiration cytology) to develop an evidence-based predictive tool for risk of malignancy.

Results

It was found that 29.1 per cent of cystic lesions were malignant on final histology. Age, male gender, non-benign ultrasound scan findings and fine needle aspiration cytology were significant risk factors on univariate analysis. The final multivariate analysis predicted a risk of malignancy ranging from 2.1 to 65.0 per cent depending on the covariate pattern. Smoking status was non-significant.

Conclusion

A rigorous, risk-stratified approach to the management of these patients should aid the clinician in minimising morbidity and optimising resources.

Keywords

Branchial cleft cystsquamous cell carcinomamalignancymetastaseslymph node
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 1 , January 2024 , pp. 99 - 104
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Victoria Evans takes responsibility for the integrity of the content of the paper

Poster presentation (commended) at the British Academic Conference in Otolaryngology, 17 February 2023, Birmingham, UK.

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