Evaluation of Neck Masses Lecture Powerpoint

Question 1

Trismus

Answer 1

Inability to fully open jaw (limited motion, lockjaw)

Question 2

Infantile hemangioma

Answer 2

Vascular congenital benign tumor in children that can be easily shrunken

Question 3

2 most common benign nonhereditary sources of pediatric neck masses and 2 most common benign hereditary ones

Answer 3

1) cervical adenitis
2) cat scratch disease
1) branchial cleft anomalies
2) thyroglossal duct cyst** (usually inferior to the hyoid and soft cystic)

Question 4

Principles of vascular lesion assessment

Answer 4

First determine if it has a pulse, then perform MRA and avoid fine needle aspiration

Question 5

Most common pediatric primary neck malignancy

Answer 5

Lymphoma

Question 6

90% rule for pediatric neck masses

Answer 6

90% are inflammatory or congenital, higher likelihood of malignancy in adults

Question 7

Recall the anterior and posterior triangles of the neck

Answer 7

anterior: mandible, SCM, midline
Posterior: clavicle, SCM, trapezius

Question 8

Recall the lymph node groups of the head and neck (10)

Answer 8

Occipital, posterior auricular, preauricular, parotid, tonsillar, submandibular, submental, superficial cervical, posterior cervical, supraclavicular

Question 9

A chronic serous otitis unilaterally in an adult is ___ until proven otherwise

Answer 9

tumor

Question 10

Red flag symptoms of head and neck cancer (5)

Answer 10

• nonhealing ulcer in oral cavity
• persistent sore throat
• dysphagia
• change in voice
• recent weight loss

Question 11

Standard of diagnosis for neck mass

Answer 11

Fine needle aspiration biopsy

Question 12

Any solid asymmetric mass in the neck must be considered ___ until proven otherwise

Answer 12

metastatic squamous cell carcinoma

Question 13

Most thyroid masses and parotid tumors are…

Answer 13

….benign in nature

Question 14

Removal of parotid tumors raises concern for…

Answer 14

…facial nerve palsy

Question 15

Carotid body tumor (paraganglioma) and diagnosis (3)

Answer 15

A highly vascular usually benign neck mass affecting chemoreceptors of the carotid body, pulsatile and if functional can cause flushing or HTN from catecholamine release, requires clinical diagnosis and plasma 24 hr urine for catecholamines followed by confirmatory angiogram or CT

Question 16

Signs that a lipoma might actually be a liposarcoma (3)

Answer 16

• pain
• rapid growth
• radiographic abnormalities

Question 17

Branchial cleft cyst and treatment (1)

Answer 17

Congenital failure of obliteration of branchial cleft during fetal development, seen in late childhood or early adulthood in the lateral portion of the neck, then surgically excised

Question 18

Most common organism of upper respiratory tract infections with associated lymphadenitis

Answer 18

Strep pneumoniae

Question 19

Bartonella henselae and treatment (1)

Answer 19

at scratch disease transmitted by flea or kitten over period of few weeks see regional lymphadenopathy, erythema, and tenderness, treated with macrolide antibiotics