We present a series of three case reports of @entity1 over the age of 40 with @entity4 in the lateral neck. Clinically they masqueraded as @entity12743 , but subsequently were diagnosed as being @entity957 cystic lymph node @entity3 arising from an occult tonsillar primary. Currently there is an absence of national guidelines for the treatment of lateral neck cysts in the over 40s' age group that subsequently prove to be cystic metastases from occult tonsillar primaries. This disease process is more common than thought, with up to 80 per cent of so-called @entity12743 in the over 40s' age group being malignant. We recommend that @entity1 over the age of 40 presenting with lateral @entity4 in the neck should have a high suspicion of @entity5 and require a panendoscopy, @entity717 and blind biopsies of @entity3521 . This avoids inadvertent excision of a possible cystic lymph node @entity3 . If the panendoscopy histology proves to be benign, then proceed to excision of the cyst with frozen section analysis of it. If this confirms it to be benign then that is all that is necessary; if the frozen section is however positive for @entity189 then the surgeon can proceed at that time to a formal neck dissection and therefore avoid a further procedure. In the event of an occult tonsillar @entity5 , excision of the cyst as part of a neck dissection with post-operative radiotherapy is recommended. It is our aim to treat a cystic lymph node @entity3 as you would a solid lymph node @entity3 .

Management of lateral XXXX of the neck, in the over 40s' age group.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignancy'] @entity4 :: ('MESH:D004487', 'Disease') :: ['cystic swellings'] @entity957 :: ('MESH:D002294', 'Disease') :: ['squamous cell carcinoma'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma'] @entity3521 :: ('MESH:D012303', 'Disease') :: ["Waldeyer's ring"] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity12743 :: ('MESH:D001935', 'Disease') :: ['branchial cysts'] @entity717 :: ('MESH:D009069', 'Disease') :: ['ipsilateral tonsillectomy']
@entity4 :: (MESH:D004487,Disease) :: ['cystic swellings']
