Purpose or Case Report: Neck masses are commonly encountered in children. The evaluation of neck mass by ultrasound is the purpose of this educational exhibit.
Methods & Materials: Ultrasound (US) is a cost-effective, examination performed without ionizing radiation or sedation; therefore, the primary imaging modality of choice to evaluate pediatric neck masses. Ultrasound cases are used to illustrate the strategy needed when faced with a pediatric neck mass. The cystic versus solid, size, shape, borders, vascularity, as well as the relationship of the mass to the nearby structures, are key elements in the workup. Clinical history and physical examination are also of great importance when evaluating the etiology of a neck mass. Pediatric neck masses are broadly divided into cystic and solid masses. The primary clue to the diagnosis is the location of the mass, especially with cystic neck masses. US is the primary imaging modality for the evaluation of masses of the neck and thyroid, including mass lesion evaluation, congenital hypothyroidism, and thyroid enlargement. All examples in our case collection had pathologically or clinically proven diagnoses and were selected from the Electronic Medical Record at our children's hospital.
Results: Cystic masses evaluated include thyroglossal duct cyst, branchial cleft cysts, thymic cysts, lymphatic malformation, dermoid, ranula, and esophageal duplication cyst. Solid neck masses include cervical lymph nodes, fibromatosis coli, ectopic thymus, pilomatrixoma, thyroid masses, ectopic thymus, rhabdomyosarcoma, and neurogenic tumors. Thyroid lesions include congenital dysgenesis/agenesis and focal or diffuse thyroid lesions. Focal thyroid lesions are either benign (such as colloid degenerative nodule)or malignant such as papillary thyroid carcinoma. Diffuse thyroid lesions are further subdivided into Graves, Hashimoto thyroiditis, and supportive thyroiditis
Conclusions: This educational exhibit will illustrate the strategic approach to ultrasound evaluation of pediatric neck masses.