Management of common head and neck masses

• Published in: Seminars in pediatric surgery Vol. 16; no. 1; pp. 3 - 13
• Main Authors: Tracy, Thomas F., MD, Muratore, Christopher S., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2007
• Subjects: Adolescent; Cervical teratoma; Child; Head and neck masses; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - etiology; Head and Neck Neoplasms - therapy; Hodgkin’s lymphoma; Humans; Infant; Pediatrics; Reactive lymphadenopathy; Surgery; Thyroglossal duct cyst; Vascular malformation; Vascular malformation; Thyroglossal duct cyst; Cervical teratoma; Reactive lymphadenopathy; Head and neck masses; Hodgkin’s lymphoma
• ISSN: 1055-8586; 1532-9453
• DOI: 10.1053/j.sempedsurg.2006.10.002

Head and neck masses are a common clinical concern in infants, children, and adolescents. The differential diagnosis for a head or neck mass includes congenital, inflammatory, and neoplastic lesions. An orderly and thorough examination of the head and neck with an appropriate directed workup will facilitate the diagnosis. The most common entities occur repeatedly within the various age groups and can be differentiated with a clear understanding of embryology and anatomy of the region, and an understanding of the natural history of a specific lesion. Congenital lesions most commonly found in the pediatric population include the thyroglossal duct cyst and the branchial cleft and arch anomalies. The inflammatory masses are secondary to local or systemic infections. The most common etiology for cervical adenopathy in children is reactive lymphadenopathy following a viral or bacterial illness. Persistent adenopathy raises more concerns, especially enlarged lymph nodes within the posterior triangle or supraclavicular space, nodes that are painless, firm, and not mobile, or a single dominant node that persists for more than 6 weeks should all heighten concern for malignancy. In this review, we discuss the current principles of surgical management of the most common head and neck masses that present to pediatricians and pediatric surgeons.