Persistent asymptomatic neck masses in an adult should, in general, be considered malignant until proven otherwise.
Final Thoughts
In conclusion, our case demonstrated a relatively rare presentation of amyloidosis as a localized neck mass with additional localization to the peritoneum discovered through a PET scan and confirmed by systemic elevation of monoclonal immunoglobulin fragments.
The teaching points raised in this case include the various presentations of amyloidosis, the variety of rheumatologic causes of neck masses, the nature and presentation of neck masses in general and the methods of evaluating a neck mass.
Tej Bhavsar, MD, is a recent graduate and former chief fellow of the University of New Mexico School of Medicine, Albuquerque. He is a practicing rheumatologist with the Center for Rheumatology based in Albany, N.Y., and sees patients in Saratoga Springs, N.Y.
Nancy Joste, MD, is director of anatomic pathology and a professor in the pathology department at the University of New Mexico School of Medicine in Albuquerque.
Acknowledgment: The authors thank Mary Barry, MD, for diagnostic assistance.
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