Neck mass differential diagnosis: Do not leave out foreign bodies

Penetrating neck injuries (both traumatic and iatrogenic) can lead to deposit of foreign bodies. These bodies may cause the formation of granulomas, even after weeks/months after the traumatic event. Despite the fact that foreign bodies granulomas are rare findings, they are essential part of the differential diagnosis for neck masses (others are branchial cysts, abscesses, lymphadenitis, lymph node metastasis, lymphomas, hemangiomas, lymphangiomas, paragangliomas, etc.). In this paper it is reported a case of a 49-year-old female complaining of a painful and hyperemic swelling in the submandibular region. A foreign body was then detected through ultrasonography and finally surgery was performed in order to remove the foreign body and to drain the inflammatory collection. This case was particularly insidious because of a silent anamnesis for recent traumatic injuries. After the diagnosis, the patient referred a road traffic accident 6 weeks earlier, which can presumably be the cause of the lesion.