Abstract
BackgroundEvaluation of palpable neck masses may be a diagnostic problem in pediatric patients, with differential diagnosis including congenital, inflammatory, tumoral and traumatic lesions. Ultrasonography is usually a satisfactory method to make a correct pre-operative evaluation of neck masses, although diagnosis is often challenging for the surgeon and the radiologist and sometimes only possible after a histopathological examination of the resected lesion.Case presentationWe report an 8-month-old patient with a cervical, anterior midline mass. Ultrasonographic images showed features suggesting a partly cystic lesion, with a preoperative suspect of thyroglossal duct cyst. Histological examination, performed after surgical removal of the mass, led to a diagnosis of lymph node angiomyomatous hamartoma (AH).ConclusionsAH, a rarely occurring benign lymph node lesion, has been reported in the neck lateral region only twice. This case, presenting as a palpable neck midline mass, is the first reported case occurring in infancy. Although rare, AH should be included in the differential diagnosis of head and neck masses.
Highlights
Evaluation of palpable neck masses may be a diagnostic problem in pediatric patients, with differential diagnosis including congenital, inflammatory, tumoral and traumatic lesions
angiomyomatous hamartoma (AH), a rarely occurring benign lymph node lesion, has been reported in the neck lateral region only twice. This case, presenting as a palpable neck midline mass, is the first reported case occurring in infancy
AH should be included in the differential diagnosis of head and neck masses
Summary
Neck lesions more commonly encountered in pediatric population consist of congenital, inflammatory or neoplastic diseases [3,5]. AH is a rare, benign form of lymph node hilar modification characterized by parenchymal replacement by fibrous tissue containing vessels and smooth-muscle proliferation. It prevalently involves inguinal lymph nodes, appearently starting in the hilum and extending towards the cortex. This entity was first described by Chan et al in 1992, and, so far, 28 cases have been reported in the literature [9,10,11,14,15,16,17,18,19,20,21,22,23]. The ultrasound image of the lump yielded a suspected cystic lesion, for the variable tissue density and for the presence of an internal fibro-vascular area contrasting with the intact lymph node periphery and providing the
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