Neck Masses In Children Research Articles

Frequency of Head and Neck Masses in Iranian Children During a 21-Year Period

Background: Head and neck masses are common in infants, children and adolescents. Etiologically, these masses are divided into three groups of inflammatory, congenital and neoplastic lesions. Their incidence rate has been variable in different parts of the world. This study aimed to determine the frequency of head and neck masses in Iranian children during a 21-year period. Methods: This retrospective, descriptive study was performed on medical files of patients between 2 to 12 years with pathological head and neck masses derived from the archives of the Pathology Department of Children’s Medical Center of Tehran from 1995 to 2016. Age, gender, time of presentation, location of the lesions and final diagnosis were collected from patients' medical records and descriptively analyzed. Results: Of 594 children, 63.3% were males and 36.7% were females (male to female ratio of 1.7:1, P < 0.001). The mean age was 6.5 years (range 2 years and 2 months to 12 years). The highest prevalence belonged to inflammatory/reactive/infectious lesions (41.7%) followed by neoplastic lesions (35.7%) and congenital/developmental lesions (22.6%). In the neoplastic group, malignant and benign lesions had 26.6% and 9.1% prevalence, respectively. Lymphoma (22.4%; 16.3% Hodgkin and 6.1% non-Hodgkin), lymphadenitis (16.2%) and thyroglossal cyst (11%) were the most prevalent lesions. Conclusions: Based on the results, inflammatory lesions had the highest incidence among the head and neck masses in children. Malignant lesions were not uncommon among Iranian children.

Etiopathological study of pediatric neck masses in a rural population

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; 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.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 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. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 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.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; 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.&lt;/p&gt;

Clinicopathological presentation of congenital neck mass in children of eastern Nepal

Clinicopathological presentation of congenital neck mass in children of eastern Nepal

Clinicopathological study of pediatric neck masses

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Pediatric neck masses are a reason for anxiety for both patients and doctor as there can be chances of malignancy. There are few established guidelines for evaluation. The etiology is varied so a thorough knowledge of clinical presentation is essential. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;A clinicopathological analysis of 150 cases of neck masses in children upto 12 years of age attending the outpatient clinic between Jan 2015 to June 2016 were included. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Maximum cases of reactive lymphadenopathy were found in our study 81 (20.7%), 23 (14.7%) thyroglossal cyst, 22 (14.7%) suppurative lymphadenopathy, mycobacterial lymphadenitis 20 (13.3%), dermoid cyst 17 (11.3%), branchial cyst 15 (10%), tubercular abscess 10 (6.7%), 3 cases (2%) each of Hodgkins lymphoma, lipoma, non-Hodgkins lymphoma were seen. FNAC was conclusive in 140 cases (93.4%). &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Percentage wise inflammatory etiology was the commonest (55.4%) followed by congenital (38.6%) and last was neoplastic (6 %). An orderly and sequential approach is needed to manage pediatric masses.&lt;/span&gt;&lt;/p&gt;

Lateral cervical thymic cyst in a child: a case report

BackgroundCervical thymic cysts are uncommon lesions, rarely considered in the differential diagnosis of neck cysts in children.Case presentationWe report a rare case of multiloculated thymic cyst in an 8-year-old boy on the right side of the neck. Perioperative diagnosis was a cystic hygroma. Macroscopic examination showed a cystic mass measuring 6.5 cm in total length. Histopathology of the excised specimen revealed thymic tissue with prominent Hassall’s corpuscles associated with multiloculated cyst. The cyst wall is bordered by a flattened or multilayered epithelium, often abraded.ConclusionThis case is presented here for its rarity and should be included in the differential diagnosis of neck masses in children. So, it’s a lesion to be well aware of, particularly by pathologists.

Pilomatrixoma of the right cheek in a young girl

Abstract Objective We report a case of pilomatrixoma of the right cheek in a healthy 4 years old girl. Method Case report and review of the English language literature (using PubMed, Ovid and Proquest databases). Results Case of right cheek pilomatrixoma occurred in a young girl to be reported in the English language literature. Conclusion Pilomatrixoma is a cutaneous neoplasm that is one of most common causes of superficial head and neck masses in children. Although the presurgical diagnosis may be difficult in some cases, pilomatrixoma must be kept in the differential of superficial head and neck masses in children. The present case highlights the importance of considering pilomatrixoma in the clinical and pathologic differential diagnosis of dermal or subcutaneous nodule even in locations other than head and neck region. Surgical excision is almost always curative.

Prevalence and pattern of neck masses in pediatric patient: in Aseer Central Hospital, KSA

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Neck masses are a common complaint in children worldwide, and constitute a major indication for surgical consultation in many pediatric surgical centers. Most of the neck masses in children are benign in their nature and clinical course. The broad spectrum of etiology of neck masses that ranged from congenital benign to acquired neoplastic lesions is varied and related to multiple factors. This retrospective study was done with the objective to assess the distribution of neck masses related to gender, age, pathology, and anatomical location of neck masses in Aseer Central Hospital. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Medical records of 62 patients with neck masses were collected from the department of pathology at Aseer Central Hospital KSA. The cases were reviewed for data on gender, age, the type of origin tissue, the type of lesion, and the anatomical location. Comparison between genders, age groups, and tissue origins were performed. All statistical tests were performed with SPSS software. We exclude thyroid, parathyroid and salivary gland masses. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Over a period of 5 years, a total of 62 patients 53.2% and women 46.8% had neck masses resected for pathological assessments. The age of presentation was ranging from 1 to 14 years. 22.6% developed in (from 1 years to 5 years old), 38.7% developed in (6 to 10 years), and 38.7% developed, in (11 to 14 years). The histopathological diagnosis of the neck masses were congenital 40.3%, inflammatory 33.9%, and malignant tumor 25.8%. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;The differential diagnosis of the pediatric neck mass includes a wide array of congenital, inflammatory, benign and malignant lesions. The exact diagnosis may only be obtained by histopathological examination. In our study the most common masses in pediatric patient thyroglossal duct cyst, all midline masses are congenital.&lt;/span&gt;&lt;/p&gt;

Clinical Practice Guideline: Evaluation of the Neck Mass in Adults.

ObjectiveNeck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise. Timely diagnosis of a neck mass due to metastatic HNSCC is paramount because delayed diagnosis directly affects tumor stage and worsens prognosis. Unfortunately, despite substantial advances in testing modalities over the last few decades, diagnostic delays are common. Currently, there is only 1 evidence-based clinical practice guideline to assist clinicians in evaluating an adult with a neck mass. Addition...

Thymus ectopique : une cause rare de tuméfaction cervicale chez le nourrisson

Ectopic cervical thymus (ECT) is a rare embryological abnormality in children. It can be revealed by a compressive neck mass mistaken for a malignant tumor. Through a new case of ECT, we review the embryopathogenesis, diagnostic difficulties and therapeutic features. A 19-month-old girl presented a right cervical mass that quickly increased in size, causing intermittent dyspnea. The physical examination objectified a 6-cm, soft and compressible, painless right cervical tumefaction, extending from the mastoid area to the ipsilateral supraclavicular fossa. The diagnosis suggested based on CT was a cervicomediastinal cystic lymphangioma. The diagnoses discussed based on MRI were a collection of necrotic lymphadenopathy, rhabdomyosarcoma or neurofibroma debris. The mass was surgically excised through a laterocervical incision. A whitish multilobular tissular mass was found, adherent to the neurovascular axis of the neck. Pathological examination concluded in normal ectopic thymus tissue. The postoperative course was uneventful. Although ECT is a rare benign anomaly, it should be considered as a possible cause of a neck mass in children. Surgery is the curative treatment. Before surgery, the presence of a mediastinal thymus must be confirmed to avoid the risk of a total thymectomy in children. MRI is helpful in delineating thymic ectopia compared to the mediastinal thymus.

Thyroglossal duct cyst: Operative technique

Thyroglossal duct cysts are the most common congenital neck masses and represent the most likely cause of central neck masses in children. Surgical excision is recommended because of the risk of infection, sinus, or fistula formation, cosmetic concerns and possible site of cancer development. While major complications are rare, recurrence continues to be a concern for the surgeon and the patient or family. Walter Sistrunk made a great contribution to surgical resection technique by using embryological information to better understand the role that the central hyoid bone may play and introducing its partial resection to improve cure rates. Over the last few decades, an improved understanding of the anatomy has further refined surgical techniques and has led to even lower recurrence rates.

Teratoma of the neonatal head and neck: A 41-year experience

ObjectiveTo review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population. DesignRetrospective case series (November 1970 through September 2011). SettingTertiary care children's hospital. Patients14 patients (12 boys and 2 girls). InterventionDetailed review of presentation, diagnostic approaches, surgical management, and outcomes. Main outcome measuresAnatomic sites, use of pre and post-natal imaging, use of EXIT (ex utero intrapartum treatment) procedure, presenting symptoms, surgical approaches, additional therapeutic modalities, and outcomes are reviewed. ResultsSeven patients were diagnosed prenatally, while the remaining 7 patients were diagnosed at birth or shortly thereafter. The tumor emanated from the neck in 9 patients, the nasopharynx/oropharynx in 3 patients, the external nose in 1 patient and the face in 1 patient. Nine patients had associated upper airway obstruction. Four underwent an EXIT procedure, with 3 requiring intubation and 1 requiring tracheostomy. All patients underwent surgical resection. One patient demonstrated recurrence at follow-up. ConclusionsTeratoma of the head and neck, though rare, is an important part of the differential diagnosis of neck masses in children, particularly in the perinatal period. The ability to make this diagnosis prenatally with high-resolution fetal ultrasound and MRI (magnetic resonance imaging) permits planning for airway and tumor management prior to delivery. An EXIT procedure should be considered when airway compromise by tumor compression is suspected. Early surgical excision is the treatment of choice and recurrence is rare when a complete resection is achieved.

A Rare Case Report of a Child Coexistence Thyroglossal Cyst and Second Branchial Cleft Fistulae

Thyroglossal duct cysts followed by branchial cleft anomalies are the most common congenital neck masses encountered in practice, second branchial cleft cysts and sinuses are the most common type (LaRiviere and Waldhausen in Surg Clin North Am 92(3):583-597, 2012). Although both abnormalities are common individually, but rarely seen associated in same patient as described in our case. Congenitalcervical anomalies are important to consider in the differential of head and neck masses in children and adults. These lesions can present as palpable cystic masses, infected masses, draining sinuses, or fistulae. Thyroglossal duct cysts are most common, followed by branchial cleft anomalies. A synchronous presentation of both type of cyst and fistula in a same child patient is very rare with no such cases reported in literature till date.

Pediatric Neck Mass

Introduction Neck masses include a wide variety of diagnostic possibilities, with more than 60 etiologies that depend on clinical aspects such as age, location and time of disease progression. The interview and physical examination guide research that cross the neck masses in pediatric patients in 3 groups: infectious / inflammatory, and neoplastic embryonic remnants. The aim of this study was to present a protocol for evaluation of neck masses in the pediatric age group, based on a review of literature on the subject and experience of this service. Materials and Methods Survey of literature data from PubMed / Medline, Google Scholar and Scopus Database without language restriction, since 1980 sources, with the MeSH term Pediatric neck mass. Results Prepared flowchart guidelines to be followed according with diagnostic suspicions. Patients were divided into 3 groups according to the initial clinical manifestations and according to etiological hypotheses formulated recommend evaluations protocols. Conclusion The standardization of the evaluation of neck masses in children proves valuable and can help in the differential diagnosis of different etiologies involved.

An Atypical Presentation of Renal Cell Carcinoma in a Child: A Neck Mass

The most common malignant diseases of the head and neck in the adolescent period are acute leukemia, Hodgkin’s disease, non-Hodgkin’s lymphoma, nasopharyngeal carcinoma, and thyroid carcinoma. Although renal cell carcinoma (RCC) may metastasize in the cervical lymph nodes, both occurrence and presentation as a neck mass are rare in the childhood period. In this report, we present a sixteen-year-old girl who was admitted with a left neck mass at presentation. The primary tumor was found to be located in the left kidney and both masses were surgically removed, revealing a diagnosis of a translocation renal cell carcinoma with metastases. Distant metastases of abdominal and thoracic malignancies may present with metastatic lymph nodes, and should be included in the differential diagnosis of the neck masses in children.

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.

Characteristics of pilomatrixoma in children: A review of 137 patients

ObjectiveTo describe our institutional experience with pilomatrixoma in the pediatric population, specifically examining its clinical presentation, associated conditions, surgical treatment and future implications. MethodsThis is a retrospective review of a single tertiary care center. Subjects included 137 patients with diagnosis of pilomatrixoma between the years of 2000 and 2013 up to the age of 19. Patient gender, age at excision, number of tumors, tumor size, tumor location, preoperative diagnosis, recurrence, patient race and zip code, along with associated medical conditions were assessed. ResultsThere were a total of 174 tumors in 137 patients. The median age at excision was 7.1 years old, with the youngest patient at 6 months and the oldest at 19 years. Head and neck tumors predominated with 70% (n=122) of all pilomatrixomas, followed by the upper extremity with 22% (38). Other locations included the hair-bearing back, chest and lower extremities. A male to female ration of 1:1.2 was observed. Tumor diameter size ranged from 0.2 to 5.2cm with an average diameter of 1.4cm. There were no cases of recurrence. Associated diagnoses included Turner syndrome and Sticker syndrome. ConclusionsPilomatrixoma, previously thought to be a rare lesion, is one of the most common causes of superficial head and neck masses in children. This study demonstrates clinical presentations that should help guide differential diagnoses. We demonstrate associations that are consistent with the proposed pathophysiology of pilomatrixoma. Surgical excision is curative.

Neck Masses in Children

Neck Masses in Children

Histology of solid lateral cervical masses biopsied in children

IntroductionSolid cervical lateral neck masses in children may require surgical biopsy to confirm appropriate diagnostic and begin a directed therapeutic treatment. We aimed to describe the contribution of pathological results and compare them with the clinical diagnosis and the paraclinical tools. MethodsA retrospective review of surgical biopsies for solid lateral neck masses in children over a ten year period in a pediatric tertiary center was conducted. Demographic, imaging, laboratory analysis, surgical and pathological data were collected and analyzed using descriptive statistics with SPSS 17.0. Results44 biopsies were done between 2002 and 2012. Inflammatory masses were found in 26/44 biopsies with half of them (13/26) being nontuberculous mycobacterial (NTM) lymphadenitis. Non-inflammatory/benign masses represented 9/44 biopsies and 5/44 masses were of malignant etiology. Malignant masses imaging had a sensitivity and specificity of 33% and 75%, respectively, for ultrasound, whereas Neck CT scan had 33% and 77%, respectively. The contribution of pathological results to the clinical management was questionable in 39% (17/44) of biopsies. ConclusionInflammatory masses with NTM lymphadenitis were the most common diagnosis. Imaging was not helpful in establishing the diagnosis. Heterogeneity in the management of solid lateral neck masses between clinicians was important and indicates the need for guideline approach.

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.

Pediatric Cervicofacial Actinomycosis: An Unusual Cause of Head and Neck Masses.

Cervicofacial actinomycosis is an unusual cause of head and neck masses in children. This low prevalence of disease in children inevitably leads to delay in clinical recognition and often requires invasive intervention for diagnosis and curative therapy. We present an illustrative case and review cases of cervicofacial actinomycosis in the pediatric literature with particular attention to clinical presentation, course, and outcome.