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Open Access Case report

Rheumatoid arthritis mimicking metastatic squamous cell carcinoma

Fernando Gomez-Rivera1, Adel K El-Naggar2, Nandita Guha-Thakurta3 and Michael E Kupferman4*

Author Affiliations

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

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Head & Neck Oncology 2011, 3:26  doi:10.1186/1758-3284-3-26

Published: 14 May 2011

Abstract

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.

Keywords:
Rheumatoid; arthritis; nodule; hyoid; larynx