Cutaneous Tumour of the Left Cricothyroid Area!?

Background: The cricothyroid area is an atypical localisation for placement of basal cell carcinomas. The main differential diagnosis for cutaneous tumours in this area is between BCC, spinocellular carcinoma and melanoma. The area is problematic about the choice of therapeutic approach, especially in the case of a vague clinical tumour type accompanied by enlarged lymph nodes in the immediate proximity.

Case Report: We present an 84- year- old woman with a tumour formation located next to the left cricothyroid area. The lymph node ultrasonography performed during the hospitalisation revealed the presence of an enlarged lymph node in the upper third of m. Sternocleidomastoideus. The initial ultrasound data of the lymph nodes were in the direction of an inflammatory rather than a metastatic process. Therefore 5 days of therapy with Ceftriaxone x 2 g/day was conducted. The nodular tumour formation was surgically removed by radical elliptic excision. The subsequent histological study found that it was Stage II basal cell carcinoma (T2N0M0). A surgeon's consultation was conducted due to a patient's complaint about abdominal pain, and clinical evidence of a hernia inguinalis incarcerata was established for which the patient was urgently transferred to a surgical ward. Two weeks after the antibiotic treatment, a control echography of the enlarged lymph node in the area of m. Sternocleidomastoideus was performed, which showed complete involution of the lymph node.

Conclusion: Due to the specific anatomical features of the neck, such as a large number of lymph nodes and the resulting proximity between them and the primary tumours located in the area, it is often difficult to determine whether the lymph nodes are metastatically affected or inflammatory enlarged. In cases of missing ultrasound data for the metastatic process in the lymph nodes, surgical excision of the skin tumour with regular follow-up echographic control of the relevant lymph nodes represents an optimal therapeutic solution.