Paediatric neck mass is a common clinical condition.

In order to understand them better, we can organize them into three types

  • Midline neck mass
  • Anterocervical- front and side of the neck
  • Posterocervical- back portion of the neck, by the side.

Each location has its own significance.

We can also organize a neck mass in children on the basis of their origin

  • Congenital - the child was born with the mass, though it may be detected later once it grows sufficiently in size
  • Inflammatory - very common in children since their immune system is developing
  • Neoplastic - which could be benign or malignant

COMMON NECK MASSES IN CHILDREN

1. CONGENITAL - Common congenital neck masses are 

  • Midline- Thyroglossal duct cyst, Ectopic Thyroid or a Dermoid Cyst 
  • Anterocervical - branchial cleft cyst, haemangioma
  • Posterocervical- vascular malformation 

2. INFLAMMATORY

  • Midline- Lymph node inflammation/ infection- usually secondary to a tonsil or dental infection. Could be viral sometimes
  • Anterocervical- Infection of the Lymph nodes or salivary gland. Sometimes Tuberculous glands may cause a swelling
  • Posterocervical- Lymph node enlargement

3. NEOPLASTIC

  • Midline- Thyroid and Parathyroid tumours
  • Anterocervical - Lymphoma, carotid body tumour etc
  • Posterocervical- Lymphoma, benign soft tissue swellings, primary or metastatic malignancies

DIAGNOSTIC WORKUP

The work up will depend upon probable cause and the location of the swelling

1. Blood tests - including a complete blood count, thyroid hormone levels etc

2. USG Neck- An ultrasound of the neck is an excellent primary investigation to look for the exact size and nature of the swelling

3. FNAC- A Fine Needle Aspiration Cytology is a specific test to determine the organ of origin as well as to know about the pathology of the problem. The Cytopathologist inserts a small needle into the mass and extracts some tissue from it. This is subjected to a microscopic analysis to come to a diagnosis.

Conclusion

  • Neck masses in children are common, 
  • They are easy to diagnose 
  • Early check-up and treatment is important