Peds Neck mass

Question 1

What is the difference between Adult and Peds NEck masses?

Answer 1

Peds MAsses mostly benign.

Most are inflammatory

Question 2

What aspects of a neck mass make you think of malignancy?

Answer 2

Atypical Time course
Atypical location
Lesion looks odd
-tethered to overlying skin
-fusiform
-fluctuant and non-tender

Question 3

What are the congenital causes of Lateral neck masses

Answer 3

Branchial Anomalies*
Fibromatosis Coli*
Laryngocele’s
Thymic Cyst

Question 4

What are the traits of T2 branchial cleft cysts?

Answer 4

Most com. lateral neck mass
Remn of 2-3rd branchial arch
Path between bifurcation of the carotid

Question 5

What are the traits of T1 Branchial cleft cysts?

Answer 5

High in the neck inferior to the ips auricle. FACIAL NERVE

Remn of division between 1-2nd branch arch

Question 6

What are the traits of Type 3 BCC?

Answer 6

Pyriform sinus fistula
Females in left neck
Remn of 3-4th Br Arch
Origin in the ips piriform sinus
Burn tract with TCA to seal off

Question 7

List the types of Inflammatory Lateral Neck masses?

Answer 7

Acute viral lymphadenitis
Acute Bact lymphadenitis
Mycobacterial lymphadenitis
Cat Scratch Dis
Infected Congen lesion
\+/- deep neck space abcess

Question 8

What are most common viral causes of lymphadenitis?

Answer 8

Rhinovirus
Parainfluenza
Influenza
EBV

Question 9

What are most common viral causes of lymphadenitis?

Answer 9

Staph Aureus
G Beta Hemolytic Strep
Anaerobic somtimes

Question 10

What are the traits of Atypical Mycobacterial infection?

Answer 10

No assoc illness, discomfort
Grad skin changes
PPD Positive (M Avium etc)
Tx w/ surgical excision
Combo Abtx Thx Ethambutol and Azithromycin

Question 11

What are the traits of Cat scratch disease?

Answer 11

Skin lesion @ inoculation
Bartonella Henselae
Self limited
Dx with serologic testing for Ab

Question 12

What are the traits of Infected congenital neck masses?

Answer 12

Lined with resp epithelium

Infection follows URI

Question 13

What are noninfectious causes of Lateral neck masses?

Answer 13

Sarcoidosis
Kawasaki
Castleman dis

Question 14

List the Midline Neck masses?

Answer 14

Thyroglossal Duct cyst
Dermoid cyst
Plunging ranula
Thymic cyst
Ectopic Thyroid

Question 15

What are the traits of TG duct cyst?

Answer 15

Remn of Mig path of thyroid (Foramen cecum=> Neck)
Cont thyroid tissue
U/S before excision
Remove center of hyoid to avoid recurrence

Question 16

What are the traits of Dermoid Cysts?

Answer 16

Difficult to diff from thyroglossal duct cyst prior to surgery
No spon resolution

Question 17

What are the traits of a plunging ranula?

Answer 17

App of Bull frog from soft swelling in submental triangle
Pseudomass from salivry accumulation
SUBLINGUAL gland source

Question 18

What are the traits of hemangioma in the neck?

Answer 18

Life threatening in airway

Shrunken by Propanolol

Question 19

What is the most common malignancy under 6yo?

Answer 19

Neuroblastoma

Question 20

What LN measurement is considered abnormal in an infant 1 yr?

Answer 20

> 1 cm

>3 cm

Question 21

What are the skin traits of a possible maligngncy?

Answer 21

Rapidly enlarging nontender long-standing mass w/ overlying skin changes W/ NS, Fever, or WL and Post Triangle loc

Question 22

What is the most common soft tissue malignancy in childhood?

Answer 22

Rhabdomyosarcoma