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Pediatric neck masses: guidelines for evaluation
A J Torsiglieri1, L W Tom, A J Ross
1Division of Otolaryngology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine 19104.
Insights
Pediatric neck masses often lack clear evaluation guidelines. This study analyzed 445 pediatric neck mass biopsies, finding congenital lesions most common and establishing diagnostic guidelines for these challenging cases.
Area of Science:
- Pediatric Otolaryngology
- Head and Neck Surgery
- Pediatric Pathology
Background:
- Neck masses are common in children, but established evaluation guidelines are scarce.
- Understanding the diverse etiologies of pediatric cervical masses is crucial for accurate diagnosis.
Purpose of the Study:
- To analyze the clinical characteristics of pediatric neck masses.
- To establish diagnostic guidelines for evaluating children with neck masses.
Main Methods:
- Retrospective analysis of 445 pediatric patients with neck masses undergoing biopsy.
- Categorization of masses into congenital, inflammatory, benign, and malignant types.
Main Results:
- Congenital lesions comprised 55% of pediatric neck masses, followed by inflammatory lesions (27%).
- Malignancies accounted for 11% of cases.
- Preoperative diagnostic accuracy was 61%.
Conclusions:
- Congenital lesions are the most frequent cause of pediatric neck masses.
- Established guidelines can improve the diagnostic accuracy for pediatric neck masses.
Abstract:
Neck masses are frequent findings in the pediatric population. Unlike the adult, there are few established guidelines for evaluation of these children. The etiology of cervical masses includes many conditions. Knowledge of these conditions and their clinical presentations is essential. To elucidate the clinical characteristics which may help in establishing a correct diagnosis, the charts of 445 patients with biopsies of neck masses performed at the Children's Hospital of Philadelphia were analyzed. There were 244 (55%) congenital lesions, 118 (27%) inflammatory lesions, 23 (5%) non-inflammatory benign masses, 12 (3%) benign neoplasms, and 48 (11%) malignancies. The preoperative diagnosis was correct in 270 (61%) patients. Guidelines are established for the evaluation of the child presenting with a neck mass.
