PEM Playbook – Neck Masses In Children

Originally published at Pediatric Emergency Playbook on October 1, 2019 – Visit to listen to accompanying podcast. Reposted with permission.

Follow Dr. Tim Horeczko on twitter @EMTogether

The Rule of 3s:

3 minutes — Traumatic

3 days — Inflammatory

3 months — Neoplastic

3 years — Congenital


3 Minutes?  Traumatic

3 Days?  Inflammatory

Cervical Node Chain; Lymphadenopathy

Bacterial Lymphadenitis

Bacterial lymphadenitis with small abscess

Large Abscess

3 Months?  Neoplastic

3 Years?  Congenital

Thyroglossal Duct Cyst

Thyroglossal Duct Cyst

Branchial Cleft Cyst

Branchial Cleft Cyst

Branchial Cleft Cyst

Cystic Hygroma

 Cystic Hygroma

Selected References

Enepekides DJ. Management of congenital anomalies of the neck. Facial Plast Surg Clin North Am 2001; 9:131.

Lin ST, Tseng FY, Hsu CJ, et al. Thyroglossal duct cyst: a comparison between children and adults. Am J Otolaryngol 2008; 29:83.

Mandell DL. Head and neck anomalies related to the branchial apparatus. Otolaryngol Clin North Am 2000; 33:1309.

Marler JJ, Mulliken JB. Current management of hemangiomas and vascular malformations. Clin Plast Surg 2005; 32:99.

Silverman, J. F., Gurley, A. M., Holbrook, C. T., Joshi, V. V. (1991) Pediatric fine needle aspiration biopsy. American Journal of Clinical Pathology 95: 653–659

Sonnino RE, Spigland N, Laberge JM, Desjardins J, Guttman FM. Unusual patterns of congenital neck masses in children. J Pediatr Surg. 1989 Oct;24(10):966-9.

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