Cervical region Flashcards
(36 cards)
Infantile hemangioma
benign vascular neoplasm GLUT-1
increased insidence in premature
-Nascent phase: subtile precursor 2-4 weeks
-Proliferative phase: (might be biphasic) bulky compressible, strawberry with cutaneous and deep components. Lobulated mass with contrast enhancement, intralesional flow voids
-Final involution: up to 12 yo, never complete
Congenital emangioma
Rare lesion completly developed at birth, without proliferative phase
- RICH: rapidly involutiong congenital hemangioma (skalp, neck) flow voids, arterial aneurysm, direct AV shunts, calcification: diff fibrosarcoma. High output congestive heart failure. Involution completed at 14 months
- NICH: non involuting congenital hemangioma. Grows with the child.
- PICH: partially involution congenital hemangioma
Kaposiform hemangioendothelioma
Locally agressive, intermediate malignancy
il defined vascular mass with stranding of subcutaneous infiltration, intralesional calcifications and feeding-draining vessels
Kasabach-Merritt
Tufted angioma
Benign vascular tumor, upper back and neck
Kasabach-Merritt
Venolymphatic
Low flow vascular malformation
- fochal nucal transluscency: when more than 3mm
- cystic hygroma: 60% associated to chromosomme abnormality (turene, T18 and T 21). Non identifiable flow
- venolymphatic malformation: large trans-spacitial multicystic masse with septa and fluid-fluid level, with some flow possible in septa. Absent calcifications. Small mass effect, considering its size
Venous malformation
slow growing lesion or dysplastic venous channels with minor lymphatic component
well defined, ovoid, heterogenous with enhancement and possible flebolites
Systemic lymphatic malformation
Lymphoangiomiomatosis:
Gorham-Stout disease: vanishing bone disease
Kaposiform lymphangiomiomatosis
Teratoma
teratomas in the neck 5-10% of all teratomas
tree layers
-mature: mostly cystic, can have calcifications and fat
-Immature
Cervical cystic masses
epidermoid: unilocular, restricted diffusion
dermoid:
thyroglossal duct cyst
laryngocele: can produce airway obstruction in newborns
Foregut duplication cyst: might or not communicate, look for it
thymic cyst: midline or anterior to SCL
Soft tissue neck mass
ectopic thymus: form primoidial thymopharyngeal dut (mandibular angle to thoracic inlet)
Fetal goiter: secondary to maternal (graves, Hashimoto)) or fetal thyroid dysfunction (US guided umbilical blood sampling)
Infantile fibromatosis
12% of pediatric soft-tissue tumors Benign: -nodular fascitis -myositis ossificans -myofibroma -fibromatosis colli Intermediate -inflammatory myofirboblastic tumors -infantile fibrosarcoma -low grade myofibroblastic sarcoma Malignant: -fibromyxoid sarcoma -adult fibrosarcoma
Nodular fasciits
head and neck followed by extremities, adolescents
more often subcutanous
rapidly developing
broad based fascial contact, and fascial tale
hypoechoic, vascular
IRM: “inverted target” sign discrete high signal centrally and lower peripherally at T2, rim of perilesional edema
can be transcompartmental
cranial fasciitis
similar to noular fascitiis in the crane
infants less than 2yo
dff: LCH, epidermoid, dermoid
Myositis Ossificans
reparative pseudosarcomatous proliferation characterized by metaplastic bone formation in striated muscle, tendons, and subcutaneous fat
post-traumatic, nontraumatic and progressive
adolescents and young adults
quadriceps femoris and the brachialis
painful soft-tissue mass that is accompanied by skin erythema, systemic findings
characteristic peripheral calcification in intermediate and mature, paraleling the long axe of the bone/muscle. Can have priosteal reaction, nome edema
Myositis ossificans progressiva
fibrodysplasia ossificans progressiva
AD
congenital malformations of the great toes nd progressive heterotopic ossification at characteristic extraskeletal sites
Gardner fibroma
1st decade
painless plaquelike mass, back and the paraspinal region in 61%
associated to desmoid fibromatosis
Infantile Myofibromatosis
the most common benign fibrous tumor in infants 90% of cases occur within the first 2 years
solitary 50-80%: firm cutaneous or subcutaneous mass, boys
Multicentric (with or without visceral involvement), more girls
hypovascular mass, can have central necrosis
spontaneous regression of the tumor over a period of 1–2 years in most cases
Fibromatosis Colli
rotation of the head are toward the side of the lesion
first 4–8 weeks of life, Male babies
fusiform enlargement of the ipsilateral sternocleidomastoid muscle
Fibrous Hamartoma of Infancy
younger than 2 years (20% at birth)
above the waist
US:heterogeneous, predominantly hyperechoic subcutaneous mass that has intervening hypoechoic regions that give it a serpentine pattern, and ill-defined or lobulated margins, poor vascularity
IRM: nonencapsulated mass with characteristic low-signal-intensity fibrous strands interspersed with high-signal-intensity fat in an organized fashion, again giving it a serpentine pattern
Soft tissue mass fat-containing
lipofibromatosis
lipoblastoma
lipofromatous hamartoma
Desmoid fibromatosis
locally aggressive recurrence 4-5 yo, second pick 3rd decade 5% of the cases of Gardner syndrome are associated with FAP often intra-abdominal
Inflammatory myofibroblastic tumor
(inflammatory pseudotumor)
around 9 yo
lung, mesentery and omentum
associated to inlammatory mediators
Grisel syndrome
cervical lymphadenitis and retropharyngeal abscess presented as post-intlammatory torticolis: atlanto-axial rotatory subluxation of C1 and C2, autolimited
Neck neuroblastoma
5% of neuroblastomas occur at neck
associated to Horner syndrome
Restricted diffusion, displastic calcification in 50%
