Cause Of Neck Mass Research Articles

When a Child has Neck Mass, Consider a Choristoma too! Here's a Rare Instance: A Cervical Chondrocutaneous Branchial Remnant.

Cervical chondrocutaneous branchial remnants (CCBR) are rare causes of neck masses in young children. It is commonly associated with genitourinary and cardiac anomalies. We report a case of CCBR in a two-year-old male child who presented with a unilateral painless pedunculated neck mass. Although ultrasonography is noncontributory, histopathology reveals a central core of hyalin cartilage with surrounding skin tissue. A diagnosis of CCBR was made on histopathology, and the patient was further clinically evaluated. The child did not reveal any other anomalies and is currently on follow-up.

Thyroglossal Duct Carcinoma: A Case Report and Literature Review

Thyroglossal duct cancer is a relatively rare finding, presenting clinical features that resemble those of a benign cyst, a more common congenital abnormality that may manifest as a lump in the midline or neck area. Thyroglossal duct cysts are a commonly found aberration during the development of the thyroid gland. The prevalence of adenotonsillar hypertrophy is greater than that of branchial cleft abnormalities, and among the pediatric population, it is the second most common cause of neck masses, surpassed only by enlarged cervical lymph nodes. In specific instances, thyroglossal duct cysts have been seen to exhibit a low prevalence of cancer. The diagnosis of thyroglossal duct cancer is commonly made by histological examination of the tumor. In addition, needle aspiration cytology, ultrasonography, and computed tomography are employed as diagnostic tools to differentiate malignant patients from alternative potential diagnosis.

Cervical Thymic Cyst - An Overlooked Entity

Thymic cysts are one of the rare causes of neck masses in the paediatric age group. Patients may complain of neck swelling either central or lateral neck swelling. There is difficulty in diagnosing a cervical thymic cyst as it may mimic a branchial cleft cyst or a cervical lymphangioma. Definitive diagnosis of a thymic cyst requires histopathological examination of thymic tissue. We report a case of a 6-year-old girl who presented with painless lateral neck swelling for 2 months duration. Computed tomography (CT) scan showed a left branchial cyst with retropharyngeal extension. The patient underwent complete excision of the mass and histological examination was reported as a cervical thymic cyst. Postoperatively, she was able to be discharged after serial follow-ups with no signs and symptoms of recurrence.

Fibromatosis colli: a rare case report

Fibromatosis colli, a rare benign congenital mass of the sternocleidomastoid muscle, is mainly found in the neonatal age group, often at the age of 2 to 4 weeks of life. Also known as a pseudo tumour, its aetiology is still unknown and may occur due to injury of the sternocleidomastoid muscle in the last trimester of intrauterine life or during delivery. Frequently manifests as restriction of neck movement and enlarging neck mass at around 14-28 days after birth. Ultrasonography (USG) neck is the preferred diagnostic modality. Treatment is mainly conservative consisting of observation and stretching exercises. Surgical intervention is required in <10% of cases and consists of a tenotomy of the sternocleidomastoid muscle. We present a case report of fibromatosis colli in a 15-day-old female neonate with a history of birth trauma presented with a right neck mass and torticollis, diagnosed using high-frequency ultrasound. This condition regressed in the next few months while the patient was instituted only conservative treatment. Thus, signifying the importance of clinical diagnosis and differentiation from other causes of neck masses to prevent unnecessary investigation and overtreatment.

Clinico-pathological evaluation of neck swellings at our tertiary care hospital

Introduction: Neck swelling can be a cause of major concern to the patients as well as the doctor in respect to the diagnosis and treatment. The neck contains a substantial amount of lymph nodes that is 35-50% of all total lymph nodes. The main causes of a neck mass are classified as congenital, inflammatory and neoplastic. FNAC is a cost-effective method and quick for sampling superficial masses found in the neck. The technique can be done in outpatient basis. Aim and Objective of the study: purpose of this study is to evaluate the various causes of Neck masses, their incidence and to correlate diagnosis with various diagnostic modalities. Materials and Methods: A detailed history-taking including age, sex, community, ethnicity, complaints and duration of symptoms, site, side etc. and with thorough clinical examination relevant investigations for consistency, diagnosis, benign or malignant was done and appropriate management has been done for these patients. Results: The correlation between FNAC and histopathology in our study was 88% (out of 100 cases, 86 cases had a positive correlation of fine needle aspiration cytology with histopathological examination).

Large non-functioning substernal parathyroid cyst: A case report and review of the literature.

ObjectivesParathyroid cysts are rare benign lesions of the head and neck that account for less than 1% of cystic neck masses. We present a rare case of a large 6 cm substernal parathyroid cyst.Presentation of caseAn otherwise healthy 65 year-old female presented to the otolaryngology clinic for evaluation of an anterior, midline neck mass. On physical exam, she was noted to have a fullness in the anterior neck extending to the sternal notch. CT demonstrated an enlarged thyroid with a cyst extending to the aortic arch. Initial evaluation suggested a bilateral goiter with substernal extension. The cyst was managed with drainage and observation. After two years of continued growth, the patient underwent a left thyroid lobectomy and mediastinal mass resection via the cervical approach. Final pathology was consistent with a parathyroid cyst.ConclusionsParathyroid cysts are a rare cause of neck mass in an adult, and a 6 cm substernal parathyroid cyst represents an unusual site and size for these cysts. Parathyroid cysts are not often considered on the differential of neck and mediastinal cystic lesions. However, appropriate steps should be taken to ensure a proper diagnosis for any cystic lesion in the neck.

Thyroglossal Duct Cyst Carcinoma in The Pediatric Population: A Case Report and Literature Review

Thyroglossal duct cyst carcinoma (TGDCa) is a rare cause of neck masses in children. Its pathophysiology stems from two main theories. One suggests that the primary carcinoma originated from ectopic thyroid tissue, whilst the other suggest it is a result of metastasis to the thyroglossal duct cyst from the thyroid gland. A case of a 12-year-old girl who presented with a suspicious neck mass and subsequently diagnosed with TGDCa is reported. A literature review was performed and we conclude that aggressive surgical management of a Sistrunk procedure, total thyroidectomy, bilateral tracheoesophageal groove clearance and neck dissection was justified for this child. We found that if the preoperative diagnosis is TGDCa, a more aggressive surgical approach tends to be taken. However, cases of recurrence remain low and a total thyroidectomy does entail a larger morbidity for the pediatric patient. Hence, we do not recommend an aggressive approach routinely. In this review, we extrapolated AJCC data for thyroid malignancies and staged the TGDCa reported in literature in the last 10 years. It showed us that pT3 tumors tend to have a more aggressive surgical course, whilst a pT1 TGDCa tend to receive a more conservative surgical approach.

Neck Masses: Clinico-Radio-Pathological Evaluation.

Neck masses are defined as any swelling or enlargement of the structures in between the inferior border of mandible and clavicle and are a common clinical finding that can be encountered in patients of all age groups. There are many potential causes of neck masses so it is important to proceed in affordable, easy available and cost effective diagnostic technique for the proper and early diagnosis of neck masses. As there is very few study data available over clinico-radio-pathological analysis of neck masses, that's why this study is done. The present study has been carried out on 200 patients with clinically palpable neck masses presenting at ENT department in a tertiary care hospital. Neck swellings were classified into four main headings i.e. Lymph node swelling, Thyroid swelling, Salivary gland swellings and Skin and soft tissue swelling. After taking detailed history followed by complete General, Local and ENT examination, FNAC was done followed by USG. We came to the conclusion that neck masses have very variable presentations, and FNAC is a riskless, easy and fast tool which can be used in forming a diagnosis and appropriate management of neck masses.

Role of Apparent Diffusion Coefficient in Characterisation of Neck Masses- A Cross-sectional Study

Introduction: Neck masses are frequently encountered in clinical practice and differential diagnoses of a patient presenting with a neck mass is wide. Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) is an imaging technique based on molecular diffusion. It is a very helpful complementary technique in distinguishing neoplastic from non neoplastic tissue and has numerous applications in the evaluation of head and neck masses especially in head and neck lymphadenopathy. Aim: To evaluate the accuracy of Apparent Diffusion Coefficient (ADC) in differentiating benign and malignant neck masses. Materials and Methods: A single-centre cross-sectional study comprising of 50 patients of all age groups with clinical suspicion of neck swelling was conducted in Department of Radiodiagnosis at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from March 2018 to February 2020. All patients included were subjected to general physical and detailed local examination. MRI was carried out on 1.5 Tesla Unit On Philips Intera Achieva using Sense Body Coil with b factor of 0 and 1000 s/mm² and ADC maps were generated and the results were compared with histopathological results and/or follow-up. Statistical assessment was carried out using Statistical Package for the Social Sciences (SPSS) version 24.0. Qualitative data were compared using the Chi-square test. Results: The most common cause of neck mass was lymph nodal masses (18%) with highest numbers of patients in age group 40-60 years (34%). When a cut-off ADC value of 1.1×10-3 s/ mm² was used, sensitivity of 95.23% and specificity of 89.65% were obtained for characterisation of malignant lesions which was statistically significant. There was a strong agreement (k value=0.838) in diagnosing the nature of lesion using ADC value on MRI with histopathological findings. Conclusion: Diffusion Weighted Imaging (DWI) and ADC values are new promising aspect of MRI and can help in differentiating the nature of the neck lesions. DWI can readily differentiate between benign and malignant lesions of neck with good efficacy and reproducibility.

Top Five Causes of Neck Mass in Chattogram

Background: Identifying top problems in any discipline is very important for diagnosis and effective management. Unfortunately there is a knowledge gap in Chattogram, Bangladesh. To fill up the gap we have conducted the study.
 Materials and methods : It was a retrospective study based on hospital records of Chattogram General Hospital from January 2017 to December 2017. All (104) cases with neck mass were included. Age, sex, clinical diagnosis, histo-pathological diagnosis and management were noted. Data were managed manually.
 Results: Total 104 cases were studied among the cases 65% were female and 35% were male. 91% cases were of 10-50 years age group. Highest cases 33% were found in 20-30 years age group. According to Histo-pathological report 25% cases were Tubercular lymphadenopathy, Nonspecific lymphadenopathy were 17% and Multi-nodular goiter were 15%. Results were contrasted with previous studies.
 Conclusion: Top 05 causes of neck mass in Chattogram have been unveiled. Tuberculosis is still number one problem. So, TB control program should be evaluated further to find out causes of high TB cases in this region.
 Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 18-20

Bilateral sternocleidomastoid tumor of infancy: a rare diagnostic dilemma

<p class="abstract">Sternocleidomastoid tumor of infancy (STOI) is a common cause of neck mass in the neonatal period. However, STOIs presenting bilaterally is a rare finding in medical literature. We herein report an unusual case of a bilateral STOI in a five-week infant. The child was given physical therapy which consisted of active and passive physical exercises, warm compresses and massage. Within 10 weeks the swellings reduced considerably in size. Bilateral, firm masses are often confused with lymphadenopathy and are inadvertently treated with antibiotics. Hence, STOI should be kept as an important differential diagnosis for neck mass in the neonatal period.</p>

Cervical thymic cyst: A rare cause of neck mass in a female adolescent

Abstract Cervical thymic cysts are an uncommon cause of a neck mass in children. Most cervical thymic cysts undergo surgical excision for diagnostic purposes; therefore, the natural progression of these lesions is not known. While these lesions are more predominant in males, we present a 15-year-old female who underwent an uneventful surgical excision of a cervical thymic cyst.

Pediatric neck masses: a clinicopathological study

<p class="abstract"><strong>Background:</strong> Pediatric neck masses are one of the most commonly presenting problems in ENT practice. Based on the etiology they are classified as infectious, congenital or neoplastic. A detailed history and physical examination are essential to establish the diagnosis and treat them. The study was undertaken to assess the clinicopathological profile of the pediatric neck masses.</p><p class="abstract"><strong>Methods:</strong> The present study was conducted for a period of 24 months between March 2015 to February 2017 in the Department of ENT, Government General Hospital Srikakulam in a tertiary care hospital in costal Andhra Pradesh.</p><p class="abstract"><strong>Results:</strong> A total of 226 patients were enrolled into the study. Of them 132 were males and 94 female. Inflammatory swelling was most common etiology (76.1%) followed by congenital (16.3%) and neoplastic (7.5%).</p><p><strong>Conclusions:</strong> In most cases of pediatrics neck masses diagnosis is made based on a detailed history and the findings of the physical examination. If radiological examination is required, US should be the first choice. Infectious and inflammatory diseases are the leading causes of neck masses in the pediatric age group.</p>

Surgical causes of neck masses in pediatrics: management and outcome

Background: Neck masses are common pathologies in pediatrics, surgery is considered the only line of treatment in most of neck lesions, and usually early intervention is recommended to avoid complications, The aim of our study is to evaluate the clinical and radiological presentations, the pathological findings, and the surgical outcome of neck lesions operated in our institution in pediatric age group.Methods: All pediatric patients presented at our pediatric surgery unit in the period from January 2017 to January 2018 by neck masses were included in this study, Patients with fistulae without underlying swellings and those with inflammatory lesions who responded to medical treatment and surgery wasn't indicated were excluded from this study. History taking, clinical evaluation, routine laboratory investigations and neck ultrasound were done in all cases, and Imaging studies (CT, MRI) were done in selected cases, all resected specimens were sent for histopathological examination, demographic data, duration of surgery, using of haemostatic devices, need of blood transfusion, duration of hospital stay, morbidity and mortality all were recorded and statistically analyzed.Results: In the majority of cases swelling was cystic in nature (69.4%), with lateral position in most of the lesions (61.2%), thyroglossal cyst proved to be the commonest (30.6%), followed by branchial cyst (22.4%). Clinical diagnosis with neck ultrasound was sufficient for diagnosis in most of the cases (55.1 %). Follow up of patients for 3 months in all cases with no mortality recorded and very low incidence of morbidity (6.1%).Conclusions: Neck swellings in pediatric population is common with wide range of differential diagnosis, with respecting anatomical and pathological backgrounds surgery has excellent outcome with very low incidence of morbidity.

Ectopic submental thyroid tissue, with no evidence of orthotopic thyroid: a case report

Background: Thyroid ectopia refers to a congenital disease with abnormal descending of the thyroid gland. The most common subtype is lingual thyroid ectopia. Sublingual and submental thyroid ectopia are much less common. It may also be found in other neck locations and distant positions .70%–90% of patients with ectopic thyroid do not have eutopic thyroid tissue. It is necessary to distinguish ectopic thyroid from other causes of neck masses. Case Presentation: A 18-year-old man was referred for the evaluation of a palpable mass in the submental region. On biochemical examination, the thyroid function tests were normal while receiving levothyroxine therapy. Ultrasonography revealed a mass measuring 4.2 × 2.7 × 2.6 cm in the submental region. The thyroid scan did not show any uptake in the thyroid region. A zone of the tracer activity was noted in the central neck, compatible with the palpated mass in the submental region. CT images showed a hyperdense soft tissue in the submental region, too. Conclusion: Thyroid ectopia is a rare condition and it is often accompanied by hypothyroidism. Ectopia often occurs in lingual and sublingual locations, and submental one is less common. Thyroid scintigraphy is the best imaging modality for the detection of thyroid ectopia. For precise localization, the CT scan correlation may be needed.

Etiopathological study of pediatric neck masses in a rural population

<p class="abstract"><strong>Background:</strong> Neck mass in pediatric age group is a common clinical condition encountered by an ENT Specialist. Detailed clinical examination and knowledge of the common neck masses in children, which differ from those in adults is vital in early diagnosis and treatment. Diagnostic modalities such as Ultrasonography, Computerised Tomography, Fine needle aspiration cytology (FNAC) and histopathological examination aids in the diagnosis of superficial neck masses. The majority of neck masses in the pediatric population are congenital or inflammatory in origin and some are neoplastic. This study was conducted to establish the various causes of neck masses and the site of origin of neck masses in pediatric patients attending ENT OPD.</p><p class="abstract"><strong>Methods:</strong> 50 patients in the age group of 1 month to 18 years presenting with neck masses to the ENT OPD of Vinayaka Mission’s Medical College and Hospital, Karaikal were included in the study. This was a prospective study conducted for a period of 2 years. All the cases underwent FNAC. Biopsy and histopathological examination was done in cases where the cytological diagnosis was inconclusive. </p><p class="abstract"><strong>Results:</strong> Of the 50 cases clinically evaluated, 24 were lymph node swellings, 7 were thyroid swellings, 8 were salivary gland swellings, 10 were congenital neck swellings, with 1 swelling being due to other cause.</p><p class="abstract"><strong>Conclusions:</strong> Inflammatory swelling arising from the Lymph nodes were the commonest cause of neck swelling in pediatric patients. Neck swellings were located most commonly in the Submandibular triangle in the study.</p>

Venous Ectasia: A Potential Mimicker for Laryngocele Radiology Covers the Road

ABSTRACT Introduction Venous ectasia is rare causes of neck mass. Among neck veins, ectasia of the internal jugular vein (IJV) are extremely uncommon. However, this is to be kept in mind when considering differentials for laryngocele. Objectives To recognize the similarities between laryngocele and ectasias of the IJV and the differences in their presentation and management. Study design Observational. Setting Tertiary care hospital, India. Conclusion Presenting a 7-year-old boy with a left-sided soft, non-tender neck mass that fluctuated in size with coughing and straining for the past 1 year, presentation classical of laryngocele. Computed tomography (CT) demonstrated marked asymmetrical dilatation of the left IJV in the neck. Color-flow Doppler ultrasonography revealed a solitary cystic lesion with evidence of high venous blood flow in the IJV area. The relevance of radiological evaluation in neck swelling is being highlighted. How to cite this article Ashish G, Kurien M. Venous Ectasia: A Potential Mimicker for Laryngocele Radiology Covers the Road. Int J Otorhinolaryngol Clin 2015;7(2):64-67.

Neck mass in a premature infant

Abstract Fibromatosis colli is the most common cause of neck mass in the neonatal period, occurring in 0.4% of live births worldwide. The pathophysiology of fibromatosis colli is unclear. The most accepted causes involve fetal malpositioning, such as breech presentation, and birth trauma with subsequent ischemia of the sternocleidomastoid muscle. We present an infant with fibromatosis colli born at the earliest gestational age and with the lowest birth weight of any case previously documented. His only risk factor for fibromatosis colli was breech presentation, a common condition at his gestational age. This case suggests alternative mechanisms may lead to fibromatosis colli.

Paediatric neck masses at a University teaching hospital in northwestern Tanzania: a prospective analysis of 148 cases.

BackgroundPediatric neck masses are one of the common surgical conditions presenting to the pediatric surgical wards and clinics in many centers worldwide. There is paucity of published information regarding pediatric neck masses in Tanzania and the study area in particular. This study determines the etiology, clinico-histopathological patterns and treatment outcome of pediatric neck masses and to identify predictors of outcome in our local setting.MethodsThis was a prospective cross-sectional hospital based study done in children aged ten years and below with neck masses for a five months period. Statistical data analysis was done using SPSS version 17.0.ResultsA total of 148 patients were studied. Their ages ranged from 2 months to 10 years (median 3 years). The male to female ratio was 2.5:1. Inflammatory lesions were the most frequent cause of neck masses accounting for 43.9% of cases. The median duration of illness was 2 years. Except for the neck mass, 72 (48.6%) of the children had clinically stable health condition on presentation. The posterior triangle was commonly involved in 118 (79.7%) patients. eight (5.4%) were HIV positive. The majority of patients (95.9%) were treated surgically. Postoperative complication rate was 30.4% and surgical site infection was the most frequent complication in 37.5% of cases. The median length of hospital stay was 10 days and was significantly longer in patients with malignant masses and those with surgical site infection (p <0.001). The overall mortality rate in this study was 8.1% and it was significantly associated with malignant masses, associated pre-existing illness, late presentation, HIV positivity, low CD 4 count, high ASA class and presence of surgical site infections (p <0.001). The outcome of patients on discharge was excellent as more than 90% of patients were successfully treated and discharged well.ConclusionPediatric neck masses are among the most common causes of paediatric surgical admissions and pose a diagnostic and therapeutic challenge in our setting. We advocate early surgical consultation and thorough and timely histopathological examination of neck masses in children.

Symptomatic Cervical Thymic Cyst: A Case Report and Literature Review

Introduction: Ectopic cervical thymic cyst is a very rare cause of neck masses in children. The diagnosis is sometimes very difficult and preoperative, correctly diagnosed thymic cysts in the neck are very low. Case Presentation: We report a 5-year-old boy with a left sided cervical mass and respiratory distress following a common cold, and ultrasound and CT scan revealed a cystic mass in the left neck with extension to the anterior mediastinum, suggesting cystic hygroma. After complete resection of the cyst and its extension, pathology report demonstrated simple thymus cyst. Discussion: Thymic cyst must be considered in differential diagnosis of a young child with a cervical mass.