Rheumatoid arthritis mimicking metastatic squamous cell carcinoma
1 Otorhinolaryngology - Head and Neck Surgery/Otolaryngology, The University of Houston Health Science Center, Houston, Texas, USA
2 Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
3 Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
4 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Head & Neck Oncology 2011, 3:26 doi:10.1186/1758-3284-3-26Published: 14 May 2011
We report a case of a cervical rheumatoid nodule in close relation to the hyoid bone mimicking a metastatic carcinoma. A 74-year-old female with a 15-year history of rheumatoid arthritis (RA) on treatment with methotrexate presented with tenderness of the right base of tongue. Imaging demonstrated a 1.4 cm cystic lesion at the hyoid bone. Biopsies were unsuccessful and the patient required surgical resection of the mass. A trans-cervical approach was used. Pathology revealed a necrotizing granuloma compatible with rheumatoid etiology. The clinician should be aware that, in a patient with a neck mass, in the presence of active RA, rheumatoid nodules should be part of the differential diagnosis.