Neck Masses in children by doctor okto. Describing various neck masses and differential diagnoses in children. This helps in proper diagnosis and management especially for ENT surgeons. Download and learn.

1. NECK MASSES IN
CHILDREN
Kevin Tony Okoth
Maseno, MBChB V
Supervisor: Dr. Okwiri Neville

2. TRIANGLES OF THE NECK

3. NECK MASS CLASSIFICATION
Lateral neck masses
• Branchial cyst
• Cystic
hygroma/lymphangiom
a
• Laryngocele
• Pseudotumor of
infancy
Midline neck masses
• Thyroglossal duct cyst
• Thymic cyst
• Submental dermoid
cyst
Entire Neck
• Hemangioma
• Lymphatic
malformations
Neck Masses can also be classified as benign or malignant

6. Branchial cyst
• Occur in 2nd and 3rd
decade of life
• Equal frequency in both
male and female
• Affects upper neck,
anterior to SCM
• Mostly due to anomalies
of the 2nd pharyngeal
arch
• Physical exam reveals
smooth, round, flctuant,
non-tender, non-
illuminable mass
• May have a sinus or
fistula
• Sinus discharging
anteriorly at SCM
externally or into the
tonsillar fossa internally
• Rx: surgical excision.

8. Cystic hygroma
• Develops as failure of
lympahtics to connect with
the venous systems and
abnormal budding of the
lympatic tissue
• Most occur in posterior
triangle of neck, 20% in the
axilla.
• No racial predominance
• Equal sex distribution
• 50-60% evident at birth,
80-90% present by age of 2
• Lateral neck mass, that
suddenly increase in size
with infection.
• Can be associated with
difficulty n breathing,
feeding and failure to
thrive.
• Soft, painless, doughy mass
that transilluminates.
• Can be associated with
turners syndrome, downs,
trisomy 18 and 13
• Rx: surgical excision

10. Thyroglossal duct cyst
• Mostly affects children
• From remnants of thyroid
duct left by descent of
developing thyroid gland
• Midline swelling, rounded
in size about 2-4 cm
• Increases in size with
upper respiratory tract
infections
• Foramen caecum usually at
the base of tongue attached
to pyramid lobes of thyroid
gland that usually involutes
at 8th week of intrauterine
life.
• Moves with protrusion of
tongue as it is attached to
base of tongue
• Rx: Sistrunk’s operation;
complete surgical excision
including body of hyoid
and core of tongue tissue.

12. Thymic Cyst
• Thymus develops from
3rd pharyngeal pouch
then descends through
neck into mediastinum.
• Thymic remnants may
persist anywhere in the
path.
• Mass can be cystic or
solid.
• A rare condition.
• Rx: Surgical excision and
sternotomy if extended
into mediastinum.

13. Sublingual dermoid cyst
• Midline, submental
swelling
• Does not move with
protrusion of the
tongue
• Mostly affect children
below 3 years
• Rx: surgical excision
Salivary gland masses
• Most calculi forms in
adolescents in
submandibular gland
• Sialadenitis of parotid
gland can occur in
mumps and reccurent
parotitis

14. Infantile hemangioma
• Malformation of blood
vessels
• Grows rapidly upto 9-
10 months then
involute upto 10 years
• Usually in children
below 6 months
Other masses
• Lymphadenitis
• Neck abcesses
• Rhabdomyosarcoma
• lymphoma