Hypertrophy of the sternoclavicular joint after functional neck dissection

Sternoclavicular joint hypertrophy is anecdotally reported as a common sequela to radical neck dissection. It is postulated that sternoclavicular joint hypertrophy is a result of a combination of spinal accessory nerve division and sternocleidomastoid muscle resection during radical neck dissection. However, we noticed that sternoclavicular joint hypertrophy can occur following functional neck dissection with preservation of the spinal accessory nerve, the sternocleidomastoid muscle and the internal jugular vein. Regardless of the aetiological factors that can lead to sternoclavicular joint hypertrophy, we believe that plain radiography and ultrasound examination of the joint, with or without fine needle aspiration or core biopsy may rule out bone metastasis with no need for further investigations. We wish to present a case of sternoclavicular joint hypertrophy following functional neck dissection to highlight the point that sternoclavicular joint hypertrophy is not solely related to division of the spinal accessory nerve and/or the sternocleidomastoid muscle.