Differential Diagnosis of Congenital Cervical Masses in Infants and Children

Kim, Wan Ju; Han, Hyung Gon; Oh, Jae Won; Lee, Ha Baik

Abstract

PURPOSE
Cervical masses are frequently occurred in children. They are most often associated with nonspecific infection. However, they may be presented as congenital abnormalities. Therefore, accurate history taking, physical examination and appropriate diagnostic procedure are absolutely required for the differential diagnosis of neck mass in children.
METHODS
To elucidate the clinical characteristics of cervical mass which may help for establishing a correct diagnosis, the clinical records including pathologic findings from the biopsied specimen of twenty-eight children under seventeen years of age who were hospitalized with complain of persistently palpable neck mass were completely reviewed.
RESULTS
Pathologic classification of the cervical mass was as follows : 15(53.6%) thyroglossal duct cyst, 7(25.0%) branchial cleft cyst, 5(17.9%) cystic hygroma and 1(3.6%) bronchogenic cyst. Asymptomatic mass was the most common presentation(67.8%). Twenty-six (92.8%) lesions were solitary and 2(7.1%) branchial cleft cyst were multiple. All thyroglossal duct cyst presented as a solitary mass and involved the midline of the neck. Branchial cleft cysts were located around sternocleidomastoid muscle, and multiple branchial cleft cyst located bilaterally in submandibular area.
CONCLUSIONS
The accurate medical history, physical examination, and additional pathologic findings are the most important for the diagnosis of congenital neck mass in children.