Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor ubiquitously associated with the Epstein-Barr virus (EBV), which is highly prevalent in South China, Southeast Asia, and North Africa. Despite being a highly radio-sensitive and treatable cancer, a majority of NPC patients are diagnosed in their advanced stage, and locoregional and distant relapses following definitive treatment contribute largely to cancer-specific mortality among these patients. Given that EBV-driven NPC is the predominant variant seen in endemic regions, various EBV detection methods have been developed and are utilized in screening, prognostication, and post-treatment surveillance of NPC patients. While the Immunoglobulin A (IgA) serology assay is the most extensively studied EBV

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This case report describes a patient with an enlarging and painless lump over the right acromioclavicular joint (ACJ). MRI showed a synovial cyst superior to the ACJ with a concomitant full-thickness tear of the supraspinatus. The patient underwent needle aspiration of the lump, which yielded 100ml of gelatinous fluid with no microbe growth. Despite repeated aspirations, the ACJ cyst continually enlarged beyond its initial size. This case report describes an ACJ cyst that enlarged in size after needle aspiration. The authors suggest surgical alternatives if cyst recurrence is observed after the initial attempt of aspiration.