Head and Neck Masses

Question 1

Name the three most common primary malignancies of the head and neck to n childhood

Answer 1

Intracranial brain tumors
Retinoblastomas
Rhabdomyosarcomas

Question 2

Name at least two of the most common locations for head and neck pediatric rhabdomyosarcomas

Answer 2

Orbit
Nasopharynx
Paranasal sinuses
Middle ear

Question 3

What are some of the MRI characteristics of head and neck rhabdomyosarcomas?

Answer 3

T1 isointense to muscle
T2 hyperintense to muscle
Heterogenous due to hemorrhage and necrosis
Contrast enhancement of stroma surrounding less enhancing nodules giving bunch of grapes or “botyroid sign”

Question 4

What are some CT characteristics of head and neck rhabdomyosarcomas?

Answer 4

Irregular ovoid masses, well circumscribed and contrast enhancing, sometimes with calcification

Question 5

Name two nasopharyngeal masses that are seen preferentially in adolescents

Answer 5

Juvenile angiofibromas (boys)
Nasopharyngeal carcinoma

Question 6

Name two tumors that secrete VMA/HMA

Answer 6

Melanotic neuroectodermal tumors of infancy (look for mass with discoloration of adjacent skin)
Neuroblastomas

Question 7

What benign tumor might cause torticollis in the first month of life?

Answer 7

Fibromatosis coli

Firm, non tender mass adherent to SCM

Regresses in first month of life

Question 8

What are some of the imaging hallmarks of solitary neurofibromas?

Answer 8

Slightly hyperintense relative to muscle

T2: periphery hyperintense, center hypointense leading to “target sign”