Neck Masses in Children: Adenopathy and Malignant Disease

Abstract

Neck masses in children are a frequent occurrence and may tax the clinical acumen of even the most astute physician. The differential diagnosis is extensive, but generally includes congenital lesions, lymphadenopathy, and malignant masses. Although the fear of malignancy accompanies virtually every child with a neck mass, cancer of the head and neck comprises only about 15 per cent of such masses in children admitted to the hospital. A logical method of evaluation is needed to prevent becoming lost in a quagmire of possibilities. By reviewing anatomy and mode of presentation, and obtaining a detailed history and careful physical examination, the physician may often arrive at a proper diagnosis on clinical grounds and confirm it with appropriate laboratory examination. In the following section, congenital lesions of the neck, lymphadenopathy, and common malignant masses will be reviewed.