Selective Pathologies of the Head and Neck in Children

Abstract

The range of pathology seen in the head and neck region is truly amazing and to a large extent probably mirrors the complex signaling pathways and careful orchestration of events that occurs between the primordial germ layers during the development of this region. As is true in general for the entire discipline of pediatric pathology, the head and neck pathology within this age group is as diverse and different as its adult counterpart. Cases that come across the pediatric head and neck surgical pathology bench are more heavily weighted toward developmental and congenital lesions such as branchial cleft anomalies, thyroglossal duct cysts, ectopias, heterotopias, choristomas, and primitive tumors. Many congenital "benign" lesions can cause significant morbidity and even mortality if they compress the airway or other vital structures. Exciting investigations into the molecular embryology of craniofacial development have begun to shed light on the pathogenesis of craniofacial developmental lesions and syndromes. Much more investigation is needed, however, to intertwine aberrations in the molecular ontogeny and development of the head and neck regions to the represented pathology. This review will integrate traditional morphologic embryology with some of the recent advances in the molecular pathways of head and neck development followed by a discussion of a variety of developmental lesions finishing with tumors presumed to be derived from pluripotent/progenitor cells and tumors that show anomalous or aborted development.

Congenital choristomas of the oral cavity in children

“…Choristomas of the oral cavity (and oropharynx and hypopharynx) should always be considered in the differential diagnosis of lesions causing neonatal airway obstruction. Other lesions that can cause neonatal airway obstruction include venolymphatic malformations, congenital granular cell tumor (epulis), teratoma, salivary gland anlage tumor, melanotic neuroectodermal tumor of infancy, congenital mucoceles or ranulas, and others 9…”

“…Using this classification, all lesions in this series would be considered teratoid. From the pathology perspective, the more common differential diagnoses in this age group and location include ranula, mucus extravasation phenomenon, thyroglossal duct cyst, vascular lesions, and hamartomatous lesions 9…”

Branchial cleft cyst: an unusual ultrasound diagnosis in an austere environment

“…A branchial cleft cyst usually arises during embryogenesis if a portion of the cleft fails to involute completely. This entrapped remnant becomes an epithelium-lined cyst located in the lateral aspect of the neck [4,6].…”

Fetal Magnetic Resonance Imaging of Head and Neck Anomalies

“…19-21). [58][59][60][61][62][63][64][65][66][67] Lymphatic malformation (LM) is a low-flow vascular malformation that is most frequently seen in the face and neck, particularly the posterior triangle. On US, LM diagnosed in the first trimester with nuchal fold thickening has a high association with chromosomal anomalies and spontaneous abortion.…”