Menu

This patient developed jaundice and an enlarging neck mass. What is the diagnosis?

A 56-year-old woman presented with jaundice and a painless mass in her left supraclavicular fossa that had become progressively enlarged during the preceding 8 weeks

 

Question

A 56-year-old woman presented with jaundice and a painless mass in her left supraclavicular fossa that had become progressively enlarged during the preceding 8 weeks.

What is the diagnosis?

Medullary carcinoma of the thyroid
Peripancreatic malignancy
Scrofula
Hodgkin’s lymphoma
Pancoast tumor

 

 

Previous Cases

Of the five conditions, a peripancreatic malignancy is the most likely to present with jaundice and Troissier's sign.

 Hussam Tom says:

ي محمد خالد ما ترحمنا

 Sam A. Mousa says:

well that's right & should be the 1st D.D.

i think it pancreatic malignancy metastasize through thoracic duct

 Sam A. Mousa says:

this may be a medullary CA as part of MEN with includes ca pacreas too, my assumtion.

jee thats skirty god help her…….,,,,,,,

yap if thre is lymph nodes at porta hepatis

Peripancreatic malignancy

 Ali Al Shidi says:

Thanks dear, I agree, very enlightening

I don't think so Ali . If we assume this is a massive TB infection involving cervical lymph nodes, then we call it TB Lymphadenitis , we only call it scrafula if there was a cold abscess draining into a sinus or there is skin ulceration.The history is probably suggestive of a malignancy , possibly a GI primary such as pancreatic Ca or other lymphoproliferative malignancy.Again like any case in medicine we cannot close the diagnosis at this point without further history, Ca and TB risk assessment and physical examination. My gut feeling this is virchow's node reflecting GI primary Pancreas or cholangiocarcinoma > After obtaining history and physical exam we can proceed with abdominal imaging and find out !

 Anahita Hamidi says:

peripancreatic mlg.

 Ali Al Shidi says:

scrofula

 Asma Khan says:

hodgkins lymphoma is possible.

 Abdul Qayyum says:

Hodgkins Lymphoma seems a possible answer. The abdominal malignancy most commonly associated with this lymphadenopathy is gastric carcinome. But the presence of jaundice may point towards peripancreatic malignancy, but so is true for Hodgkin lymphoma.

peripancreatic malignancy

 Michael Lee says:

aka Virchow's node (Troisier's sign)

 Michael Lee says:

Peripancreatic malignancy

 Chandra Nanjiani says:

its peripancreatic malignancy.

 Nausheen Sohail says:

Peripancreatic malignancy

 Shabin Jamal says:

peripancreatic cancer

 Cylene Gómez says:

Hodgkin’s lymphoma

peripancreatic malignancy