A Bump In The Neck

Question:  A 50 year old female presents with a posterolateral neck mass. She states that this mass has been present for as long as she can remember but slowly got larger with a recent episode of weight gain.  It is non tender, there are no overlying skin changes, it is not ballottable and does not transilluminate.  You do not appreciate a thrill or bruit.  She is a non-smoker, non-drinker, denies previous personal history of cancer or radiation treatment.  You obtain an MRI scan which demonstrates high signal on T1 weighted imaging, high signal on fast spin echo T2 weighted imaging, and is isointense to the subcutaneous fat on fat-suppressed imaging.  What is your diagnosis?   [Answer will be posted with next week's new question]

Answer to last week's question, A Bump In The Road (October 12, 2015): 

This likely represents a granulation polyp or post traumatic granuloma.  It will likely regress on its own without intervention.  Medical options include initiating a steroid inhaler and antireflux medication, as well as considering voice therapy.  Repeat laryngoscopy should be performed in 4-6 weeks.  It the lesions grows or the patient becomes symptomatic, one should consider repeat direct laryngoscopy and biopsy as recurrent carcinoma should always be on the differential.