[Neck masses in childhood. Surgical experience in 154 cases]

Neck masses of children often constitute a complex problem of diagnosis and treatment. Despite the currently available diagnostic techniques, excisional biopsy still remains the procedure of first choice in a high percentage of cases to obtain a definitive diagnosis. In the present research, we analyze the problems of differential diagnosis and surgical treatment of neck masses in children, on the basis of 154 cases recruited in 20 years (at the Dept. of Surgery of the University of Pisa). Specific and unspecific lymphadenitis were observed in 26 (16.9%: and 18 cases 18 cases (11.7%), respectively. Hodgkins' lymphoma was present in 12 patients (7.8%). Thyroid disorders were diagnosed in 48 cases; 31 (20.1%) of these were benign, and 17 (11.1%) were malignant. Thirty-nine children showed congenital anomalies: 26 (16.9%) suffered from cysts of the thyroglossal duct, 10 (6.5%) from branchial abnormalities, and 3 (1.9%) from cystic lymphangioma. Two dermoid cysts (1.3%) and 2 parotid gland mixed tumours (1.3%) were also observed. The deep knowledge of embryology and anatomy of the neck, a careful clinic examination, an echography, as well as a fine needle-aspiration, seem thus essential to achieve the correct diagnosis and treatment.