Primary Care Case Challenge: An Accountant With Bilateral Neck Masses

Djamil Fertikh, MD


March 02, 2022

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.


A 66-year-old man presents to his primary care physician complaining of bilateral, palpable, nontender neck masses. The patient states that the lesions first appeared about 2 months ago and have been progressing. He reports no recent viral infection, fever, chills, or any other associated systemic symptoms.

The patient's medical and surgical history is only remarkable for type 2 diabetes. He has not had any illicit drug use. The patient works as an accountant and lives in an apartment with his mother and two younger sisters. No pets live in the home.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.