Paediatric neck masses – a diagnostic dilemma

Abstract

Three hundred and sixty children who had a head and neck mass excised during 1987 to 1992 at the Royal Hospital for Sick Children, Glasgow were studied. There were 210 males and 150 females with a mean age of 60.7 months (0.5 to 198 months). Pilomatrixomata/sebaceous cysts (34 per cent), thyroglossal cysts (13 per cent), branchial remnants (nine per cent) and dermoids (nine per cent) accounted for almost twothirds of the 264 non-lymphadenomatous benign lesions excised. Ninety-three lymphadenopathy masses consisted of 60 with reactive hyperplasia, 21 with Mycobacterium infection and 12 lymphomas. There were three solid malignant tumours, two were rhabdomyosarcomata and one disseminated round cell tumour. The correlation between clinical diagnosis and histopathology of benign non-lymph node masses and solid tumours was 90 per cent and 100 per cent respectively, in benign lymph nodes, 66 per cent, but was poor in differentiating lymph node content. The mean time from presentation of a swelling to its excision was almost a year and the mean in-patient stay for excision of a mass was almost five days. The role of fine needle aspiration cytology (FNAC) in arriving at a diagnosis and reducing patient morbidity is discussed.

Clinicopathological profile of cervicofacial masses in pediatric patients

“…All cases were managed surgically (Sistrunk's operation) without any recurrence. Rajesh et al [13] usually did not report any case of thyroglossal cyst in their study of head and neck masses in children, while as Connolly and Mackenzie reported 13% of cervicofacial masses in children as thyroglossal cysts [1]. The incidence of male to female ratio found in present study is consistent with other studies.…”

“…These fi ndings do not confer with most authors [1,7,8,13,14] . This percentage of chronic saliadenitis can be attributed to poor orodental hygiene.…”

“…Four cases of foreign body granulomas and 2 cases of pyogenic granuloma were treated by excision and the remaining 2 pyogenic granuloma were managed conservatively. Most of the authors did not report granulomas in the pediatric age group [1,13,14].…”

“…There were 4 cases (1%) of dermoid cysts, both females, in the present study, both were excised surgically. Rajesh et al [13] reported 4% of cervicofacial masses in children as dermoids whereas Connelly and Meckenzie [1] reported 9% of cervicofacial masses as dermoids.…”

Epidermoid Cysts in Head and Neck: Our Experiences, with Review of Literature

“…In fact, in some of the recent studies, the role of FNAC as an important tool in the diagnostic work-up in various epidermal lesions has been underlined and well-explored, like in nose and paranasal sinus masses that included epidermal inclusion cysts [16], in pediatric neck masses like dermoids, sebaceous cysts etc. [17], and in specific skin adnexal lesions like pilomatrixoma [17,18].…”