Let's face it - 13 unusual causes of facial masses in children
Jacqueline du Toit1, Nicole Wieselthaler2
1Department of Radiology, Red Cross Children's Hospital, Klipfontein Road, Rondebosch, 7700, South Africa. jacqueline.dut@gmail.com.
Insights
Facial swelling in children often indicates infection but can stem from various rare causes. Magnetic Resonance Imaging (MRI) aids in diagnosing these diverse conditions, including tumors and congenital lesions.
Area of Science:
- Pediatric Radiology
- Medical Imaging
- Differential Diagnosis
Background:
- Facial swelling is a common pediatric presentation.
- Etiologies range from infection to neoplastic and congenital causes.
- Accurate diagnosis is crucial for appropriate management.
Purpose of the Study:
- To present rare causes of pediatric facial swelling.
- To illustrate imaging findings of diverse etiologies on MRI.
- To aid in the diagnostic process for unusual cases.
Main Methods:
- Retrospective review of 136 MRI examinations (April 2007 - May 2013).
- Selection of 13 cases representing rare conditions.
- Analysis of imaging findings and clinical presentations.
Main Results:
- Included HIV-associated malignancies (plasmablastic lymphoma), parotid tumors (hamartoma), congenital lesions (thyroid fetiform teratoma), and infections (mandibular tuberculosis).
- Demonstrated the utility of MRI in visualizing a wide spectrum of rare facial swellings.
- Minimal literature available for some imaging findings.
Conclusions:
- Facial swelling in children has varied causes beyond infection.
- MRI is the preferred modality for assessing facial swelling.
- A diagnostic flowchart was developed to assist in rare pediatric facial swelling cases.
Unlabelled:
Facial swelling is commonly encountered in paediatric patients and is typically related to an underlying infection. The spectrum of possible causes, however, is wide, and includes traumatic, inflammatory, nutritional and neoplastic aetiologies. In this pictorial essay we present 13 examples of rare conditions selected from a total of 136 MRI examinations performed at our institution between April 2007 and May 2013. These include HIV-associated malignancies such as a case of plasmablastic lymphoma, parotid gland tumours including a parotid hamartoma, rare congenital lesions such as a thyroid fetiform teratoma, and infective lesions including tuberculosis of the mandible. In many cases, only minimal information could be gleaned from the literature, particularly with regard to imaging findings. An analysis of the spectrum of masses and specific clinical presentations allowed for the construction of a diagnostic flowchart which may serve to assist in unusual cases.
Teaching Points:
• Facial swelling is commonly encountered in paediatrics, with a wide spectrum of possible aetiologies. • MRI is the favoured imaging modality for accurate assessment. • Facial swelling is typically infectious in nature, but includes various benign and malignant causes. • This pictorial essay presents 13 examples of rare conditions with corresponding imaging.
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