Figure 6.

A 52-year-old woman with papillary carcinoma and a retropharyngeal metastasis. She had a history of fibromyalgia and presented with 1 year of right-sided neck pain. On clinical examination, she was found to have right neck adenopathy and an enlarged right thyroid lobe, subsequently proven to contain papillary thyroid carcinoma. A contrast-enhanced CT scan was performed before thyroid carcinoma was suspected. (a) Axial enhanced CT image shows subtle asymmetry of the prevertebral muscles (arrows). (b) The same axial enhanced CT image with narrowed window width shows a metastatic right retropharyngeal node (arrow) to be much more conspicuous. This case highlights the subtlety of retropharyngeal nodes on CT, which may be even more problematic when contrast is not given.