- Neoplasia in children is rare
- Most head and neck lumps result from congenital or inflammatory processes
Anterior triangle
- Lymphadenopathy
- Primary infection - tuberculosis, toxoplasmosis
- Secondary infection - lymphadenitis
- Primary tumours - Hodgkin's' or non-Hodgkin's lymphoma
- Secondary tumours
- Thyroglossal cysts
- Dermoid cyst
- Goitre
- Branchial cyst
Posterior triangle
- Lymph nodes
- Cystic hygroma
- Sternomastoid tumours
- Parotid swellings
Branchial remnants
- Branchial sinuses and cysts arise from second branchial sinus
- Arise on anterior border of sternomastoid
- Often bilateral and extend deep into neck
- Internal opening occasionally found in tonsillar fossa
- Treatment is by surgical excision
Picture provided by Ben Nwomeh, Pittsburgh Children's Hospital, Pittsburgh, USA
Cystic hygroma
- Hamartomatous lymphatic malformations resulting in multi-cystic mass
- 60% are found in neck region
- Often present in early childhood as expanding mass
- Contain clear fluid and transilluminate brightly
- Large lesions can be diagnoses prenatally and can result in obstructed labour
- Surgical excision is difficult and can result in a poor cosmetic result
- Sclerosants my be useful
Picture provided by Mazhar Raja, Armed Forces Hospital, Jubail, Saudi Arabia
Picture provided by M H Randhawa, FMH College of Medicine and Dentistry
Sternomastoid tumours
- Mass in middle third of sternomastoid muscle
- Results from muscle damage during labour
- Presents with neck lump and torticollois away from affected side
- Treatment should involve physiotherapy to correct the torticollois
- Surgery to the lump is rarely required.
Bibliography
Davenport
M.
Lumps and swellings of the head and neck. Br Med J 1996;
312:
368-371
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