Neck masses in children

Question 1

Thyroglossal cyst

Answer 1

Anterior triangle
Usually midline, below hyoid bone
Derived from remnants of thyroglossal duct
Thin walled and anechoic on USS

Question 2

Branchial cyst

Answer 2

Usually located anterior to sternocleidomastoid near the angle of the mandible
Unless infected the fluid in the cyst has a similar appearance to water and is anechoic on USS

Question 3

Dermoids

Answer 3

Derived from pleuripotent stem cells and located in the midline
Most commonly in suprahyoid region
Heteregenous appearance on imaging and contain variable amounts of calcium and fat

Question 4

Thyroid gland

Answer 4

Usually represent thyroglossal cysts or tumours e.g. lymphoma in children

Question 5

Lymphatic malformations

Answer 5

Usually located posterior to sternocleidomastoid
Cystic hygroma results from occlusion of lymphatic channels
Painless, fluid filled lesion usually present before 2 years
Often closely linked to surrounding structures and surgical removal can be difficult
Typically hypoechoic on USS

Question 6

Infantile haemangioma

Answer 6

May present in either triangle of neck
Grow rapid initially then will often spontaneously regress
Plain x-rays will show a mass lesion, usually containing calcified phleboliths

Question 7

Lymphadenopathy

Answer 7

Either triangle

Reactive or neoplastic