Pediatric neck masses: how clinical and radiological features can drive diagnosis

Riva, Giuseppe; Sensini, Matteo; Peradotto, F; Scolfaro, Carlo; Rosa, Gianpaolo Di; Tavormina, Paolo

doi:10.1007/s00431-018-3305-9

Cited by 21 publications

(17 citation statements)

References 15 publications

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“…This likely reflects the strict exclusion criteria that was used for our study population, as our aim was to describe asymptomatic, pediatric cervical lymphadenopathy. Additionally, while the incidence of new diagnosis of malignancy is low, the majority of pediatric malignant cases present with high clinical suspicion, even prior to imaging or surgical biopsy for confirmation [6][7][8][9]. This suggests that in asymptomatic clinical presentations, surgical biopsy may be deferred, and these findings are consistent with our study.…”

Section: Discussionsupporting

confidence: 88%

Management of Persistent Pediatric Cervical Lymphadenopathy

Wai¹,

Wang²,

Lee³

et al. 2020

AOHNS

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Clinical data extracted from charts included pertinent antecedent symptoms, medical history, and physical exam features including lymph node location, consistency, and overlying skin changes. Lymph node location were classified as follows: anterior cervical (defined as lymphadenopathy overlying the sternocleidomastoid or anterior to the muscle), posterior cervical (any lymph node posterior to the sternocleidomastoid), submandibular, submental, postauricular and supraclavicular. All lymphadenopathy dimensions, noted on either physical exam or ultrasound report, were reported using the largest dimension. If multiple lymph nodes were present, the largest lymph node was used. Ultrasound imaging reports were also reviewed for any commentary on nodal architecture or abnormal features.

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Section: Discussionsupporting

confidence: 88%

Management of Persistent Pediatric Cervical Lymphadenopathy

Wai¹,

Wang²,

Lee³

et al. 2020

AOHNS

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“…Clinical features of lymphadenopathy such as painless lymph nodes larger than 2-3 cm in diameter with hard, irregular and firm consistency have been reported as suggestive of malignancy ( 22 ). However, a recent study suggested that these features are not only associated with malignant tumors, since they observed also similar clinical features in 25–41% of chronic nonspecific lymphadenopathies and mycobacteriosis, and in 60% of acute/subacute lymphadenopathies ( 10 ).…”

Section: Discussionmentioning

confidence: 98%

“…Overall, the signs and symptoms reported in this study are in line with those of previous studies, with a tumor/swelling being the most common clinical finding in all cancer types ( 11 ). As mentioned in the literature, head and neck masses in pediatric patients are extremely common, and they often represent a clinical manifestation of congenital, inflammatory, and benign lesions ( 10 ). Thyroglossal cyst (31%), plunging ranula (17%), and lymphangioma (16%) have been the main diagnoses of head and neck masses in children and adolescents ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations of head and neck cancer in pediatric patients, an analysis of 253 cases in a single Brazilian center

Arboleda¹,

Pérez-de-Oliveira²,

Hoffmann³

et al. 2022

Med Oral

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Background Pediatric head and neck cancer (PHNC) is rare and its nonspecific clinical manifestations may often lead to delayed diagnosis. We aimed to describe the signs, symptoms, and clinicopathological characteristics of PHNC. Material and Methods Medical records were retrospectively reviewed for all PHNC cases diagnosed from 1986 to 2016 affecting patients aged 19-years and younger from a tertiary referral center in Brazil. Demographic variables, anatomical site of primary tumors, histopathological diagnoses, signs and symptoms, and patterns of misdiagnosis were collected and interpreted by statistical and descriptive analysis. Results A total of 253 PHNC cases were included. The mean age was 9.3 years and male patients were more frequently affected (60.9%). Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common cancer types. The nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were the predominant anatomical sites. Tumor/swelling (68.4%), was the clinical finding often presented. The univariable analysis showed association between tumor histology and clinical variables such as sex ( p =0.022), age ( p <0.0001), anatomical location ( p <0.0001) tumor/swelling ( p =0.034), pain ( p =0.031), systemic/general manifestations ( p =0.004), nasal/breathing alterations ( p =0.012), orbital/ocular alterations ( p <0.0001). Misdiagnosis such as tonsillitis, otitis, and abscess were frequent. Conclusions Although the clinical findings of PHNC are often unspecific, this study provided signs and symptoms with significant correlations between tumor histology. The suspicion of malignancy should be considered when the main signs and symptoms reported here appear and persist, in order to conduct a timely diagnosis. Key words: Head and neck, cancer, children, adolescent, signs, symptoms.

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“…There are a few studies that investigate LNM in adult population, while, to the best of our knowledge, there is no large study that investigates LNM in pediatric population. Authors Riva et al reported a monocentric study with 190 pediatric patients with neck masses localized in all regions of the neck [ 15 ]. The three largest studies investigating LNM in adult population included data from 135 patients and were monocentric [ 16 , 17 ], and multicentric [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and ultrasound characteristics of pediatric lateral neck masses

2021

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Lateral neck masses (LNM) often present a diagnostic challenge in the practice of pediatric plastic surgeon. The aim of this study is to investigate the clinical and ultrasound (US) characteristics of pediatric LNM in order to make mutual comparison between their entities and enable the most accurate preoperative diagnosis. A cross-sectional study was conducted among 250 pediatric patients treated by surgical excision or sclerotherapy in our institution in the period from July 2009 to June 2019. Lymphatic malformation was the most frequent congenital LNM (60.9%), while reactive or granulomatous lymphadenitis was the most frequent acquired LNM (47%). Congenital anomalies were significantly more often localized in the upper half of the sternocleidomastoid (SCM) muscle region, and had more often soft consistency than acquired ones. Congenital LNM had a 32.37 (3.44–304.63) times higher likelihood of incorrect (p = 0.002) and 5.86 (1.35–25.48) times higher likelihood of undetermined (p = 0.018) than correct US findings, respectively. Acquired LNM were significantly more often localized in the region behind the SCM muscle and more often had solid US appearance in comparison to the congenital ones. Association of the clinical and US findings is very important in determining the most accurate preoperative diagnosis without exposing the children to unnecessary utilizing ionizing radiation or anesthesia. Although they are mostly benign, extreme caution is necessary due to malignancies which were found in 16.4% of all our patients.

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Pediatric neck masses: how clinical and radiological features can drive diagnosis

Cited by 21 publications

References 15 publications

Management of Persistent Pediatric Cervical Lymphadenopathy

Management of Persistent Pediatric Cervical Lymphadenopathy

Clinical manifestations of head and neck cancer in pediatric patients, an analysis of 253 cases in a single Brazilian center

Clinical and ultrasound characteristics of pediatric lateral neck masses

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