Peds Neck mass Flashcards
What is the difference between Adult and Peds NEck masses?
Peds MAsses mostly benign.
Most are inflammatory
What aspects of a neck mass make you think of malignancy?
Atypical Time course Atypical location Lesion looks odd -tethered to overlying skin -fusiform -fluctuant and non-tender
What are the congenital causes of Lateral neck masses
Branchial Anomalies*
Fibromatosis Coli*
Laryngocele’s
Thymic Cyst
What are the traits of T2 branchial cleft cysts?
Most com. lateral neck mass
Remn of 2-3rd branchial arch
Path between bifurcation of the carotid
What are the traits of T1 Branchial cleft cysts?
High in the neck inferior to the ips auricle. FACIAL NERVE
Remn of division between 1-2nd branch arch
What are the traits of Type 3 BCC?
Pyriform sinus fistula Females in left neck Remn of 3-4th Br Arch Origin in the ips piriform sinus Burn tract with TCA to seal off
List the types of Inflammatory Lateral Neck masses?
Acute viral lymphadenitis Acute Bact lymphadenitis Mycobacterial lymphadenitis Cat Scratch Dis Infected Congen lesion \+/- deep neck space abcess
What are most common viral causes of lymphadenitis?
Rhinovirus
Parainfluenza
Influenza
EBV
What are most common viral causes of lymphadenitis?
Staph Aureus
G Beta Hemolytic Strep
Anaerobic somtimes
What are the traits of Atypical Mycobacterial infection?
No assoc illness, discomfort Grad skin changes PPD Positive (M Avium etc) Tx w/ surgical excision Combo Abtx Thx Ethambutol and Azithromycin
What are the traits of Cat scratch disease?
Skin lesion @ inoculation
Bartonella Henselae
Self limited
Dx with serologic testing for Ab
What are the traits of Infected congenital neck masses?
Lined with resp epithelium
Infection follows URI
What are noninfectious causes of Lateral neck masses?
Sarcoidosis
Kawasaki
Castleman dis
List the Midline Neck masses?
Thyroglossal Duct cyst Dermoid cyst Plunging ranula Thymic cyst Ectopic Thyroid
What are the traits of TG duct cyst?
Remn of Mig path of thyroid (Foramen cecum=> Neck)
Cont thyroid tissue
U/S before excision
Remove center of hyoid to avoid recurrence
What are the traits of Dermoid Cysts?
Difficult to diff from thyroglossal duct cyst prior to surgery
No spon resolution
What are the traits of a plunging ranula?
App of Bull frog from soft swelling in submental triangle
Pseudomass from salivry accumulation
SUBLINGUAL gland source
What are the traits of hemangioma in the neck?
Life threatening in airway
Shrunken by Propanolol
What is the most common malignancy under 6yo?
Neuroblastoma
What LN measurement is considered abnormal in an infant 1 yr?
> 1 cm
>3 cm
What are the skin traits of a possible maligngncy?
Rapidly enlarging nontender long-standing mass w/ overlying skin changes W/ NS, Fever, or WL and Post Triangle loc
What is the most common soft tissue malignancy in childhood?
Rhabdomyosarcoma
