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Evaluation of

neck masses
inflammatory disorder Attempt
Treat to determine source of mass, and
CT, MRI, arteriography, angiography, • Factors suggestive
primary of canc
or metastat
investigation is unnecessary further
Imagingdiagnostic
studies: Not •medically.
Duration
routinely and growth
information ••rate
is needed ofor
mass
Salivary desired
Thyroglossal duct•cysts
glands Oral cavity • Salivary gland tumors
and • Nasal cavity and nasopharynx
Consider investigative
• studies:
Factors suggestive of cancer assess
Drain its physical
abscesses.
• Location characteristics. Examine
and the
plain x-rays are Attempt
sometimes to determine source of mass, and
FNA isInflammatory
diagnostic oror confirmatory Congenital cystic lesion FNA investigation
yieldscalled isfor,
negative
Benign unnecessary
but ultrasonography,
or inconclusive
neoplasm resultsof mass Malignant and branchial
oropharynx
neoplasm Determine
•cleft cystsand hypopharynx
Larynx • Thyroid nodules and goiters
Biopsy: Fine-needle aspirationCT, MRI, arteriography, following areas in detail:
Consider
angiography, investigative helpful. Consultation
studies: assess
with its physical characteristics. Examine the
a head
infectious disorder Ask about • (treated surgically)
Nasal cavity • and
Duration and growth
nasopharynx • Soft
ratetissue
of mass tumors
(FNA) is preferred method. and plain x-rays •
are Cervical
sometimes Biopsy:
lymph Fine-needle
nodes • Skin • and neck
aspiration
Formulate initial
Thyroid radiologist
diagnostic following
is desirable.
impressions areas in detail: Perform physical exam
These include Repeat FNA These orinclude
perform open biopsy. • Factors suggestive Determine of•infection
Cystic hygromas
whether is and of mass • Chemodectomas
or • Location
cancer
Imaging studies: Not routinelyhelpful. Consultation • Salivary
with a (FNA)
glands
head
inflammatory is •preferred
Oral
disorder method.
cavity and
hemangiomas (treated • Cervical
• lymph
Neurogenic nodes
tumors• Skin • Thyroid head and nec
Formulate initial diagnostic
Treat medically. impressions Perform physical examination of primary or metastatic. Ask about
• Thyroglossal duct
called for, butcysts
ultrasonography, • andSalivary
neck gland tumors
radiologist oropharynx
is desirable.Imaging
• studies:and
Larynx Not routinely
hypopharynx • Salivary glands • Oral cavity and
Drain abscesses. head and 09/08 •
neckand goiters Factors suggestive of expectantly)
cancer •
• Factors suggestive of infection orLaryngeal tumors
and branchial
CT, MRI,cleft cysts
arteriography, • Thyroid
angiography, nodules calledandfor,nasopharynx
but ultrasonography, Look for Prim
• Nasal cavity oropharynx • Larynx
Treat surgically. and hypopharynx
(Observation
(treatedandsurgically)
plain x-raysLook are sometimes • Soft tissue tumors inflammatory disorder • Asymmetry • Signs of tr
for CT, MRI, arteriography,
FNA is diagnostic or confirmatory angiography, • Nasal cavity and nasopharynx
• Cystichelpful.
hygromas and • Asymmetry
Consultation with •a head Chemodectomas • Factors suggestiveisofappropriate cancer in some
FNA yields cases.) or
negative inconclusive
• Skin Theseresults
changes •include
Moveme
Inflammatory or Congenital cystic lesion Benign neoplasm • Signs of traumaMalignant and plain
neoplasm x-rays are sometimes
Formulate initial diagnostic
hemangiomas impressions Diagnosis is probable, and Diagnosis is uncertain, or further deglutition • Bruit • Vo
and neck(treated
radiologist is •
desirable. Neurogenic tumors
• Skin changes • Movement of mass on further diagnostic Perform
helpful. physical
Consultation examination
with a of
head • Lymphoma •
infectious disorder FNA is diagnostic or confirmatory head andnegative
neck information is neededRepeat FNA or perform open biopsy.
or desired
Diagnosis is probable, and Diagnosis is uncertain,expectantly)
or further deglutition • Laryngeal
• Bruit tumors
• Vocal changes
Determine and FNA
neck
whether cancer
yields
radiologistis is or inconclusive
desirable. results Attempt to • Upper
determine aerodi
source
These include These include investigation is unnecessary
further diagnostic information is needed or desired Formulate initial diagnostic
Treat surgically. (Observation impressions Performinvestigative
Consider physical examination
studies: of • Softcharacteris
assess its physical tissue sar
Treat medically. • Thyroglossal duct cysts • Attempt
Salivary gland to determine
tumors source of primary
Lookand
mass, or metastatic.
for
investigation is unnecessary is appropriate in some cases.) Repeat FNA or perform open biopsy. head andaspiration
Fine-needle neck following areas in detail:
Drain abscesses. Consider
andinvestigative studies:
branchial cleft cysts • Thyroid assess its physical
nodules characteristics. Examine
and goiters • Asymmetry the • Signs of trauma Biopsy: Treat with surger
The
FNA is diagnostic
Fine-needle
Biopsy:(treated or
aspirationconfirmatory following areas in detail: • Skin changes
FNA yields negative or inconclusive results • Movement of mass on
Look for(FNA) is preferred method. • Cervical chemotherapy,
lymph nodes •as
surgically) • Soft tissue tumors • L
Diagnosis is probable, and Diagnosis is uncertain, or further deglutition • Bruit • Vocal changes Imaging studies: Not routinely • Salivary glands • Oral c
(FNA) is preferred method.
• Cystic hygromas and • Chemodectomas
• isCervical FNA is diagnostic Inflammatory
• Skin •orThyroid confirmatoryor Congenital cystic lesion
• Asymmetry
FNA yields • Benign
Signs ofortrauma
negative neoplasm
inconclusive results Malignant neopl
further diagnostic information neededlymph or desirednodes
Repeat FNA or perform
infectious open
disorder biopsy. called for, but ultrasonography, oropharynx • Larynx
• U
an
studies: Not routinely
Imaginghemangiomas (treated • Neurogenic tumors
• Salivary glands • Oral cavity Attempt and • Skin changes •
to determine source of mass, and CT, MRI, arteriography, angiography, Movement of mass on • S
investigation is unnecessary Diagnosis is probable, and Diagnosis is uncertain, orcharacteristics.
further
These include These include • NasalDetermine
cavity andwhethernasophac
called for, but ultrasonography,
expectantly) Inflammatory or•further
Consider Laryngeal tumors
oropharynx
investigative
Congenital •
studies: Larynx
cystic lesion assess
and hypopharynx itsBenign
physicalneoplasm Examine deglutition
the
Repeat FNA
Malignant •orBruit
perform• Vocal
neoplasm open changes
biopsy.
diagnostic information
Treat is needed
medically. ordetail:
desired and plain x-rays are sometimes primary or metastati Trea
Me
CT, MRI, arteriography, angiography, 09/08 following areas in • Thyroglossal duct cysts •source
Salivary
infectious
and plain x-rays are sometimes (FNA)
Treat
Biopsy:
disorder • Nasal
surgically.
Fine-needle
investigation is unnecessary
cavity and nasopharynx
(Observation
aspiration
Drain abscesses.
Attempt to determine
helpful. Consultation with agland
of mass,
headandtumors chem
is appropriate
is preferred
These in some cases.)
method.
include These include
Consider •investigative
Cervical studies:
lymph nodes and branchial
• Skin cleft
assess
• Thyroid itscysts
Determine
and physical
neck whether • Thyroid
cancer
characteristics.
radiologist isnodules
Examineand
is desirable. thegoiters
helpful. Consultation withTreatamedically.
head Imaging studies: Not routinely (treated surgically) primary
following areasor •
metastatic.
in detail: Soft tissue tumors
• Thyroglossal duct cysts Biopsy: Fine-needle
• Salivary aspiration
glands
• Salivary gland tumors • Oral cavity and
and neckor radiologist is desirable.
Congenital cystic
calledlesion Benign neoplasm
Inflammatory Drain abscesses. for, but ultrasonography,
and branchial cleft cysts (FNA) is preferred oropharynx
• Thyroid method. •Malignant
Larynx
nodules •andandneoplasm
Cystic hygromas and
hypopharynx
goiters • Chemodectomas
• Cervical lymph nodes • Skin • Thyroid
infectious disorder CT, MRI, arteriography, angiography, ImagingCongenital cystic lesion hemangiomas (treated
Benign neoplasm • Neurogenic tumors
09/08 These include and plain x-raysinfectious
Inflammatory
(treated surgically)
Thesedisorder
or • Nasal
studies:
• Soft
include called for, but ultrasonography,
Not routinely
cavity
tissue and nasopharynx
tumors
Determine whether cancer• isSalivary glands • Oral cavity andMalignant neoplasm
are sometimes
• Cystic hygromas and • Chemodectomas expectantly) • Laryngeal tumors
primary oropharynx • Larynx and hypopharynx
Treat medically. • Thyroglossal helpful. Consultation
duct cysts with
• a head
Salivary gland CT, tumors
These
MRI, include
arteriography, FNA or
angiography,
metastatic. or confirmatory
is diagnostic
These include Treat surgically. FNAwhether
Determine yields negative
(Observation cancer
Primaryisor is
inconclusive
known re
hemangiomas (treated • Neurogenic tumors • Nasal cavity and nasopharynx
Drain abscesses. and branchial and cleft
neckcysts
radiologist
Treat ismedically.
• desirable.
Thyroid nodules
and and
plain goiters
x-rays are sometimes is appropriate primary
in some or metastatic.
cases.)
FNA is diagnostic or confirmatory expectantly)
FNA yields negative or inconclusive results • Laryngeal
• Thyroglossal duct cysts tumors • Salivary gland tumors
(treated surgically) Drain•abscesses.
Soft tissue tumors helpful. Consultation with RepeatMetastatic
FNA or perform
squamousopen biopsy.
andTreat
branchial cleftacysts
surgically. head
(Observation • Thyroid nodules and goiters cell carcinoma:
• Cystic hygromas and •
Repeat FNA or perform open biopsy. Chemodectomas and neck radiologist
is appropriateis desirable.
in some cases.) • Soft tissue tumors Perform selective neck dissection, a
(treated surgically)
hemangiomas (treated • Neurogenic tumors Primary
consider neoplasm
adjuvant radiation therap
• Cystic hygromas and • Chemodectomas
09/08 expectantly) • Laryngeal tumors Metastatic adenocarcinoma: Primary
Perform is
FNA is diagnostic or confirmatory FNA yieldshemangiomas (treated
negative or inconclusive results• Neurogenic tumors These include
Treat surgically. (Observation expectantly) • Laryngeal tumors neck dissection (selective or other),
is appropriate in some cases.) Inflammatory or Congenital cystic lesion • Lymphoma
Benign neoplasm • Thyroid
and consider Metastatic
adjuvant cancer Malign
squamous
radiation ce
FNA is diagnostic or Repeat FNA
confirmatory or perform open biopsy. FNA yields
infectious disorder Treat surgically.
negative or (Observation
inconclusive results • Upper aerodigestive tract selective
Perform cancer neck
Inflammatory or Congenital cystic lesion Benign neoplasm Malignant neoplasm therapy.
is appropriate
These include in some cases.) • Soft Metastatic
These include tissue sarcoma • Skin
consider
melanoma: cancer
Determine
adjuvant
Perform rad
full-
infectious disorder Repeat FNA or perform open biopsy.
Treat medically. • Thyroglossal duct cysts thickness
Treat gland
• Salivary with surgery, Metastatic
excision and
tumors radiation therapy, primary
adenocarcino
SLN biopsy
and/or
These include These include Determine whether cancer is
09/08
primary or metastatic. Drain abscesses. and branchial cleft cysts if
chemotherapy,there are
as
• Thyroid nodules and goiters neck
positive dissection
appropriate. SLNs or (select
lymph
Treat medically. • Thyroglossal duct cysts • Salivary gland tumors
(treated surgically) • Soft tissue tumors and consider
nodes are palpable, perform adjuvan
modif
Drain abscesses. Inflammatory or
and branchial cleft cysts Congenital cystic lesion
• Thyroid nodules and goiters Benign neoplasm Malignant neoplasm
• Cystic hygromas and • Chemodectomas neck dissection.therapy.
infectious
(treated disorder 09/08 • Soft tissue tumors
surgically) Metastatic melanoma: P
Determine hemangiomas (treated • Neurogenic tumors
• Cystic hygromas and These include
• Chemodectomas
Inflammatory or These include cystic lesion
Congenital Benignwhether
neoplasm cancer is Malignant neoplasm thickness
Metastatic tumorexcision and
Treat medically. primary or metastatic. expectantly) • Laryngeal tumors
hemangiomas (treated • •Thyroglossal
Neurogenic tumors
infectious
duct disorder
cysts • Salivary gland tumors if there are positive SL
Drain abscesses.
expectantly) •and
Laryngeal tumors Determine whether Treat surgically.
cancer is(Observation
branchial cleft cysts •These
Thyroid include
nodules and goiters These include nodes are palpable, pe
09/08
Treat medically. primary or is appropriate in some cases.)
metastatic.
Treat surgically.
(treated (Observation
surgically) • •Soft tissue tumors
Thyroglossal duct cysts • Salivary gland tumors neck dissection.
•is Cystic Draininabscesses.
appropriate
hygromas someand cases.)
09/08 • Chemodectomas
and branchial cleft cysts • Thyroid nodules and goiters Prim
hemangiomas (treated • Neurogenic tumors
(treated surgically) • Soft tissue tumors
expectantly) • •Laryngeal tumors and
Cystic hygromas • Chemodectomas Metastatic squam
hemangiomas
Treat surgically. (treated
(Observation • Neurogenic tumors Primary is known PerformPrimary
selectiv
expectantly)
is appropriate in some cases.) • Laryngeal tumors consider adjuva
Treat surgically. (Observation Metastatic squamous cell carcinoma: Metastatic
Evaluate adeno
naso
is appropriate in some cases.) Perform selective neck dissection, and neck dissection
esophagus, hy
consider adjuvant radiation therapy. and consider ad
tracheobronch
Metastatic adenocarcinoma: Perform therapy.
endoscopically
09/08 neck dissection (selective or other), Metastatic
Biopsy nasophmelan
09/08 and consider adjuvant radiation thickness
and hypophar excisi
therapy. ifPerform
there areunilaposi
Metastatic melanoma: Perform full- nodes
followedare palpa
by ir
thickness excision and SLN biopsy; neck
entire dissection
pharynx
if there are positive SLNs or lymph
09/08
nodes are palpable, perform modified
neck dissection.
09/08
inflammatory disorder Attempt
Treat to determine source of mass, and
CT, MRI, arteriography, angiography, • Factors suggestive
primary of canc
or metastat
investigation is unnecessary further
Imagingdiagnostic
studies: Not •medically.
Duration
routinely and growth
information ••rate
is needed ofor
mass
Salivary desired
Thyroglossal duct•cysts
glands Oral cavity • Salivary gland tumors
and • Nasal cavity and nasopharynx
Consider investigative
• studies:
Factors suggestive of cancer assess
Drain its physical
abscesses.
• Location characteristics. Examine
and the
plain x-rays are Attempt
sometimes to determine source of mass, and
FNA isInflammatory
diagnostic oror confirmatory Congenital cystic lesion FNA investigation
yieldscalled isfor,
negative
Benign unnecessary
but ultrasonography,
or inconclusive
neoplasm resultsof mass Malignant and branchial
oropharynx
neoplasm Determine
•cleft cystsand hypopharynx
Larynx • Thyroid nodules and goiters
Biopsy: Fine-needle aspirationCT, MRI, arteriography, following areas in detail:
Consider
angiography, investigative helpful. Consultation
studies: assess
with its physical characteristics. Examine the
a head
infectious disorder Ask about • (treated surgically)
Nasal cavity • and
Duration and growth
nasopharynx • Soft
ratetissue
of mass tumors
(FNA) is preferred method. and plain x-rays •
are Cervical
sometimes Biopsy:
lymph Fine-needle
nodes • Skin • and neck
aspiration
Formulate initial
Thyroid radiologist
diagnostic following
is desirable.
impressions areas in detail: Perform physical exam
These include Repeat FNA These orinclude
perform open biopsy. • Factors suggestive Determine of•infection
Cystic hygromas
whether is and of mass • Chemodectomas
or • Location
cancer
Imaging studies: Not routinelyhelpful. Consultation • Salivary
with a (FNA)
glands
head
inflammatory is •preferred
Oral
disorder method.
cavity and
hemangiomas (treated • Cervical
• lymph
Neurogenic nodes
tumors• Skin • Thyroid head and nec
Formulate initial diagnostic
Treat medically. impressions Perform physical examination of primary or metastatic. Ask about
• Thyroglossal duct
called for, butcysts
ultrasonography, • andSalivary
neck gland tumors
radiologist oropharynx
is desirable.Imaging
• studies:and
Larynx Not routinely
hypopharynx • Salivary glands • Oral cavity and
Drain abscesses. head and •
neckand goiters Factors suggestive of expectantly)
cancer •
• Factors suggestive of infection orLaryngeal tumors
and branchial
CT, MRI,cleft cysts
arteriography, • Thyroid
angiography, nodules calledandfor,nasopharynx
but ultrasonography, Look for Prim
• Nasal cavity oropharynx • Larynx
Treat surgically. and hypopharynx
(Observation
(treatedandsurgically)
plain x-raysLook are sometimes • Soft tissue tumors inflammatory disorder • Asymmetry • Signs of tr
for CT, MRI, arteriography,
FNA is diagnostic or confirmatory angiography, • Nasal cavity and nasopharynx
• Cystichelpful.
hygromas and • Asymmetry
Consultation with •a head Chemodectomas • Factors suggestiveisofappropriate cancer in some
FNA yields cases.) or
negative inconclusive
• Skin Theseresults
changes •include
Moveme
Inflammatory or Congenital cystic lesion Benign neoplasm • Signs of traumaMalignant and plain
neoplasm x-rays are sometimes
Formulate initial diagnostic
hemangiomas impressions Diagnosis is probable, and Diagnosis is uncertain, or further deglutition • Bruit • Vo
and neck(treated
radiologist is •
desirable. Neurogenic tumors
• Skin changes • Movement of mass on further diagnostic Perform
helpful. physical
Consultation examination
with a of
head • Lymphoma •
infectious disorder FNA is diagnostic or confirmatory head andnegative
neck information is neededRepeat FNA or perform open biopsy.
or desired
Diagnosis is probable, and Diagnosis is uncertain,expectantly)
or further deglutition • Laryngeal
• Bruit tumors
• Vocal changes
Determine and FNA
neck
whether cancer
yields
radiologistis is or inconclusive
desirable. results Attempt to • Upper
determine aerodi
source
These include These include investigation is unnecessary
further diagnostic information is needed or desired Formulate initial diagnostic
Treat surgically. (Observationimpressions Performinvestigative
Consider physical examination
studies: of • Softcharacteris
assess its physical tissue sar
Treat medically. • Thyroglossal duct cysts • Attempt
Salivary gland to determine
tumors source of primary
Lookand
mass, or metastatic.
for
investigation is unnecessary is appropriate in some cases.) Repeat FNA or perform open biopsy. head andaspiration
Fine-needle neck following areas in detail:
Drain abscesses. Consider
andinvestigative studies:
branchial cleft cysts • Thyroid assess its physical
nodules characteristics. Examine
and goiters • Asymmetry the • Signs of trauma Biopsy: Treat with surger
The
FNA is diagnostic
Fine-needle
Biopsy:(treated or
aspirationconfirmatory following areas in detail: • Skin changes
FNA yields negative or inconclusive results • Movement of mass on
Look for(FNA) is preferred method. • Cervical chemotherapy,
lymph nodes •as
surgically) • Soft tissue tumors • L
Diagnosis is probable, and Diagnosis is uncertain, or further deglutition • Bruit • Vocal changes Imaging studies: Not routinely • Salivary glands • Oral c
(FNA) is preferred method.
• Cystic hygromas and • Chemodectomas
• isCervical FNA is diagnostic Inflammatory
• Skin •orThyroidconfirmatoryor Congenital cystic lesion
• Asymmetry
FNA yields • Benign
Signs ofortrauma
negative neoplasm
inconclusive results Malignant neopl
further diagnostic information neededlymph or desirednodes
Repeat FNA or perform
infectious open
disorder biopsy. called for, but ultrasonography, oropharynx • Larynx
• U
an
studies: Not routinely
Imaginghemangiomas (treated • Neurogenic tumors
• Salivary glands • Oral cavity Attempt and • Skin changes •
to determine source of mass, and CT, MRI, arteriography, angiography, Movement of mass on • S
investigation is unnecessary Diagnosis is probable, and Diagnosis is uncertain, orcharacteristics.
further
These include These include • NasalDetermine
cavity andwhethernasophac
called for, but ultrasonography,
expectantly) Inflammatory or•further
Consider Laryngeal tumors
oropharynx
investigative
Congenital •
studies: Larynx
cystic lesion assess
and hypopharynx itsBenign
physicalneoplasm Examine deglutition
the
Repeat FNA
Malignant •orBruit
perform• Vocal
neoplasm open changes
biopsy.
diagnostic information
Treat is needed
medically. ordetail:
desired and plain x-rays are sometimes primary or metastati Trea
Me
CT, MRI, arteriography, angiography, 09/08 following areas in • Thyroglossal duct cysts •source
Salivary
infectious
and plain x-rays are sometimes (FNA)
Treat
Biopsy:
disorder • Nasal
surgically.
Fine-needle
investigation is unnecessary
cavity and nasopharynx
(Observation
aspiration
Drain abscesses.
Attempt to determine
helpful. Consultation with agland
of mass,
headandtumors chem
is appropriate
is preferred
These in some cases.)
method.
include These include
Consider •investigative
Cervical studies:
lymph nodes and branchial
• Skin cleft
assess
• Thyroid itscysts
Determine
and physical
neck whether • Thyroid
cancer
characteristics.
radiologist isnodules
Examineand
is desirable. thegoiters
helpful. Consultation withTreatamedically.
head Imaging studies: Not routinely (treated surgically) primary
following areasor •
metastatic.
in detail: Soft tissue tumors
• Thyroglossal duct cysts Biopsy: Fine-needle
• Salivary aspiration
glands
• Salivary gland tumors • Oral cavity and

09/08
and neckor radiologist is desirable.
Congenital cystic
calledlesion Benign neoplasm
Inflammatory Drain abscesses. for, but ultrasonography,
and branchial cleft cysts (FNA) is preferredoropharynx
• Thyroid method. •Malignant
Larynx
nodules •andandneoplasm
Cystic hygromas and
hypopharynx
goiters • Chemodectomas
• Cervical lymph nodes • Skin • Thyroid
infectious disorder CT, MRI, arteriography, angiography, ImagingCongenital cystic lesion hemangiomas (treated
Benign neoplasm • Neurogenic tumors
09/08 These include and plain x-raysinfectious
Inflammatory
(treated surgically)
Thesedisorder
or • Nasal
studies:
• Soft
include called for, but ultrasonography,
Not routinely
cavity
tissue and nasopharynx
tumors
Determine whether cancer• isSalivary glands • Oral cavity andMalignant neoplasm
are sometimes
• Cystic hygromas and • Chemodectomas expectantly) • Laryngeal tumors
primary oropharynx • Larynx and hypopharynx
Treat medically. • Thyroglossal helpful. Consultation
duct cysts with
• a head
Salivary gland CT, tumors
These
MRI, include
arteriography, FNA or
angiography,
metastatic. or confirmatory
is diagnostic
These include Treat surgically. FNAwhether
Determine yields negative
(Observation cancer
Primaryisor is
inconclusive
known re
hemangiomas (treated • Neurogenic tumors • Nasal cavity and nasopharynx
Drain abscesses. and branchial and cleft
neckcysts
radiologist
Treat ismedically.
• desirable.
Thyroid nodules
and and
plain goiters
x-rays are sometimes is appropriate primary
in some or metastatic.
cases.)
FNA is diagnostic or confirmatory expectantly)
FNA yields negative or inconclusive results • Laryngeal
• Thyroglossal duct cysts tumors • Salivary gland tumors
(treated surgically) Drain•abscesses.
Soft tissue tumors helpful. Consultation with RepeatMetastatic
FNA or perform
squamousopen biopsy.
andTreat
branchial cleftacysts
surgically. head
(Observation • Thyroid nodules and goiters cell carcinoma:
• Cystic hygromas and •
Repeat FNA or perform open biopsy. Chemodectomas and neck radiologist
is appropriateis desirable.
in some cases.) • Soft tissue tumors Perform selective neck dissection, a
(treated surgically)
hemangiomas (treated • Neurogenic tumors Primary
consider neoplasm
adjuvant radiation therap
• Cystic hygromas and • Chemodectomas
09/08 expectantly) • Laryngeal tumors Metastatic adenocarcinoma: Primary
Perform is
FNA is diagnostic or confirmatory FNA yieldshemangiomas (treated
negative or inconclusive results• Neurogenic tumors These include
Treat surgically. (Observation expectantly) • Laryngeal tumors neck dissection (selective or other),
is appropriate in some cases.) Inflammatory or Congenital cystic lesion • Lymphoma
Benign neoplasm • Thyroid
and consider Metastatic
adjuvant cancer Malign
squamous
radiation ce
FNA is diagnostic or Repeat FNA
confirmatory or perform open biopsy. FNA yields
infectious disorder Treat surgically.
negative or (Observation
inconclusive results • Upper aerodigestive tract selective
Perform cancer neck
Inflammatory or Congenital cystic lesion Benign neoplasm Malignant neoplasm therapy.
is appropriate
These include in some cases.) • Soft Metastatic
These include tissue sarcoma • Skin
consider
melanoma: cancer
Determine
adjuvant
Perform rad
full-
infectious disorder Repeat FNA or perform open biopsy.
Treat medically. • Thyroglossal duct cysts thickness
Treat gland
• Salivary with surgery, Metastatic
excision and
tumors radiation therapy, primary
adenocarcino
SLN biopsy
and/or
These include These include Determine whether cancer is
09/08
primary or metastatic. Drain abscesses. and branchial cleft cysts if
chemotherapy,there are
as
• Thyroid nodules and goiters neck
positive dissection
appropriate. SLNs or (select
lymph
Treat medically. • Thyroglossal duct cysts • Salivary gland tumors
(treated surgically) • Soft tissue tumors and consider
nodes are palpable, perform adjuvan
modif
Drain abscesses. Inflammatory or
and branchial cleft cysts Congenital cystic lesion
• Thyroid nodules and goiters Benign neoplasm Malignant neoplasm
• Cystic hygromas and • Chemodectomas neck dissection.therapy.
infectious
(treated disorder 09/08 • Soft tissue tumors
surgically) Metastatic melanoma: P
Determine hemangiomas (treated • Neurogenic tumors
• Cystic hygromas and These include
• Chemodectomas
Inflammatory or These include cystic lesion
Congenital Benignwhether
neoplasm cancer is Malignant neoplasm thickness
Metastatic tumorexcision and
Treat medically. primary or metastatic. expectantly) • Laryngeal tumors
hemangiomas (treated • •Thyroglossal
Neurogenic tumors
infectious
duct disorder
cysts • Salivary gland tumors if there are positive SL
Drain abscesses.
expectantly) •and
Laryngeal tumors Determine whether Treat surgically.
cancer is(Observation
branchial cleft cysts •These
Thyroid include
nodules and goiters These include nodes are palpable, pe
09/08
Treat medically. primary or is appropriate in some cases.)
metastatic.
Treat surgically.
(treated (Observation
surgically) • •Soft tissue tumors
Thyroglossal duct cysts • Salivary gland tumors neck dissection.
•is Cystic Draininabscesses.
appropriate
hygromas someand cases.)
09/08 • Chemodectomas
and branchial cleft cysts • Thyroid nodules and goiters Prim
hemangiomas (treated • Neurogenic tumors
(treated surgically) • Soft tissue tumors
expectantly) • •Laryngeal tumors and
Cystic hygromas • Chemodectomas Metastatic squam
hemangiomas
Treat surgically. (treated
(Observation • Neurogenic tumors Primary is known PerformPrimary
selectiv
expectantly)
is appropriate in some cases.) • Laryngeal tumors consider adjuva
Treat surgically. (Observation Metastatic squamous cell carcinoma: Metastatic
Evaluate adeno
naso
is appropriate in some cases.) Perform selective neck dissection, and neck dissection
esophagus, hy
consider adjuvant radiation therapy. and consider ad
tracheobronch
Metastatic adenocarcinoma: Perform therapy.
endoscopically
09/08 neck dissection (selective or other), Metastatic
Biopsy nasophmelan
09/08 and consider adjuvant radiation thickness
and hypophar excisi
therapy. ifPerform
there areunilaposi
Metastatic melanoma: Perform full- nodes
followedare palpa
by ir
thickness excision and SLN biopsy; neck
entire dissection
pharynx
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09/08
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Finis

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