Neck Masses In Children Research Articles

Head and Neck Masses in Children

Educational objective: To develop an evaluation protocol and a treatment plan for a head or neck mass in a child.

Neck Masses in Children

Educational objectives: To develop a practical approach to the evaluation of a child with a neck mass and to become familiar with etiologies, clinical diagnosis, and management of midline, lateral, and posterior neck masses.

CT Findings of Palpable Neck Masses in Children

CT Findings of Palpable Neck Masses in Children

Aberrant cervical thymus in children: Three case reports and review of the literature

Aberrant migration of thymic tissue occurs with ectopic thymus in the mediastinum, base of the skull, tracheal bifurcation, and cervical region. A recent review of the literature showed a total of 76 reported cases of aberrant thymus or thymic cysts in patients who presented with primary neck masses. We report three additional cases of ectopic cervical thymus. All three patients presented with asymptomatic cervical masses, and preoperative diagnosis included branchial cleft cyst, cervical lymphangioma, and cervical teratoma. All patients underwent complete surgical resection of the masses. Aberrant cervical thymus rarely produces symptoms because it does not invade contiguous stryctures. Despite its rarity, it should be considered in the differential diagnosis of asymptomatic neck masses in children.

Sonography of neck masses in children: is it useful?

111 patients aged two days to 20 years with neck masses were examined by ultrasound. Results were compared to subsequent histo-pathological or clinical diagnosis. Sonography allowed us to divide neck masses into two groups, a sonospecific group in which an accurate presurgical diagnosis was made in 92%, and a non-sonospecific group. The sonospecific group contained 48 patients and included thyroid masses, cystic hygromas, certain cases of adenopathy and a cervical myelomeningocele. The non-sonospecific group contained 63 patients and included a variety of neck masses such as dermoid cysts, branchial cleft cysts, the majority of cases of adenopathy, hemangiomas, lymphangiomas and various other neoplastic masses. Sonography serves to delineate the extent of neck masses, define the relationship of the mass to the thyroid and major neck vessels and guide fine needle aspiration biopsy.

Sonography of neck masses in children.

The sonograms and medical records of 49 patients were reviewed to determine if there is a characteristic sonographic appearance for certain neck masses. Neck masses included: inflammatory masses (12), noninflammatory masses (23), and thyroid masses (14). Four entities including thyroglossal duct cyst, fibromatosis colli, cystic hygroma, and multiple lymphadenopathy showed characteristic sonographic appearance. Thyroglossal duct cysts were seen as midline or slightly off midline cystic masses. A sinus tract extending superiorly was nicely demonstrated in one patient. The mass in fibromatosis colli (neonatal torticollis) appeared as a well defined mass clearly within the sternocleidomastoid muscle, uniformly echogenic, but less echogenic than the normal surrounding muscle, without good through-transmission. A cystic or primarily cystic mass with linear septations was the characteristic finding of the cystic hygroma. Multiple lymphadenopathy demonstrated multiple discrete, oval, relatively hypoechoic masses along the cervical lymphatic chain. The sonographic appearance of inflammatory masses was variable, being either inhomogeneously echogenic or of mixed echogenicity. Hemangiomas were either echogenic with cystic vascular spaces or linear septations or relatively homogeneously echogenic. Intrinsic thyroid masses could be distinguished from extrinsic masses in most cases. The demonstration of calcification in a mass was useful in narrowing the differential diagnosis. Although it is not a specific finding, the presence of calcification highly suggests a neoplastic lesion, particularly neuroblastoma or teratoma. Not only can the location, extent, and internal characteristics of a mass be determined, but in certain entities, the sonographic appearance is characteristic and an accurate diagnosis can be made.

Ultrasound evaluation of neck masses in children.

Neck masses in children are a frequent occurrence and in some instances create a diagnostic dilemma for the clinician. The authors' two-year experience using ultrasonography in the evaluation of 34 children with neck masses is reviewed. Twenty-two patients had lesions arising outside the thyroid gland; 12 lesions arose from the thyroid gland. Ultrasonography proved to be an accurate imaging modality for localizing the mass and demonstrating its relationship to the thyroid gland, trachea, and major neck vessels. The borders and extent of the lesions were well outlined, as well as their internal consistency. Based on this review, the authors recommend that ultrasonography be the first screening procedure in pediatric patients who present with perplexing neck masses.

Teratomas of the head and neck in childhood

Teratomas are tumors consisting of tissue arising from all three embryonic germ layers. Their occurrence in the head and neck region is rare. Three patients with this lesion are presented. Although exhibiting progressive uncoordinated growth, histologic evidence of malignancy in the head and neck form of this tumor is distinctly uncommon. Mortality associated with teratomas is most often secondary to respiratory compromise. Complete surgical extirpation is the treatment of choice to lower mortality and recurrences. The use of fine needle aspiration in the management of neck masses in children is discussed.

The diagnosis and treatment of midline neck masses in children

The diagnosis and treatment of midline neck masses in children

The diagnosis and treatment of midline neck masses in children: P. J. Knight, A. B. Hamoudi, and L. E. Vassy. Surgery 93:603–611, (May), 1983

The diagnosis and treatment of midline neck masses in children: P. J. Knight, A. B. Hamoudi, and L. E. Vassy. Surgery 93:603–611, (May), 1983

Sonographic evaluation of non-inflammatory neck masses in children.

A review of the sonographic findings in 17 children with non-inflammatory neck masses suggests that while ultrasound is nonspecific with regard to the differential diagnosis, it can show whether a mass is cystic, solid, or complex. Sonography is also useful in clarifying the anatomical extent of a lesion and involvement of underlying normal structures.

Third branchial cleft sinus: an unusual cause of neck abscess

Sinuses and fistulae of the third branchial cleft or pouch are rarely encountered. We have cared for a child with a history of multiple neck masses and abscesses, in whom the causative factor seems to have been an unrecognized branchial cleft sinus. This case suggests the need for contrast radiography of the hypopharynx in children with recurrent neck abscess, and dramatizes the need to exercise all reasonable diagnostic options before proceeding with surgery of newly presenting neck masses in children.

Neck Masses in Children: Adenopathy and Malignant Disease

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.

Neck Masses in Children: Diagnosis and Treatment

Neck masses in children most often represent benign lymphadenitis due to infection. The involved lymph nodes are usually small, shotty, diffusely distributed, and superficial. They may be tender and associated with an acute upper respiratory infection or with chronic infection of the tonsils and adenoids. Enlargement of the jugulodigastric node is most often associated with tonsillitis, and the spinal accessory group of nodes with adenoiditis. Acute viral diseases may be associated with lymphadenopathy; mononucleosis is the most striking example. The differential diagnosis must include deep neck-space abscesses, congenital cysts, and benign as well as malignant neoplasms. A diagnosis can be derived from a consideration of the history and physical findings, the age of the patient, and the location, size, and consistency of the mass. A careful otolaryngologic exam--including the nasopharynx, a chest radiograph, and appropriate blood studies--should be routine. When malignancy is suspected, a biopsy of the mass is indicated.

The Diagnosis of Head and Neck Masses in Children

The Diagnosis of Head and Neck Masses in Children