Diagnosis: Localized swelling, mass and lump, neckClinical question: right supraclavicular mass , low grade vascular neoplasmSigns and Symptoms: eval extent of mass to vessels MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. MRI neck:There is a 48 x 28 mm heterogeneous mass centered in the right supraclavicular area which is surrounded by adjacent vasculature including the subclavian artery and vein as well as thyrocervical trunk. Along its superior medial aspect there is a 12 x 9 mm axial dimension fluid collection present there is infiltration of the surrounding fat planes. There are punctate foci of signal loss within this lesion with slight susceptibility effect. The skin surface superficial to the lesion is irregular and somewhat disrupted. Some blood products are present within the adjacent subcutaneous tissues.Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses are intact. The paranasal sinuses and mastoid air cells are clear.The parotid and the submandibular glands appear intact.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.
1.There is a right supraclavicular mass associated with surrounding inflammatory changes and findings suggesting recent surgery. No arterial blood supply is appreciated. A biopsy of this lesion indicates that this represents a hemangioma. Given this biopsy information, certainly the findings are consistent with a recent biopsy of a hemangioma. A follow-up cross-sectional exam after the inflammatory changes regress may help further evaluate this.