Neck masses in children are most often benign. One of the most commonly diagnosed benign neck masses is an enlarged lymph node. Lymph nodes help to fight infection, so they will often swell up during an upper respiratory infection. Usually, these “swollen glands” are tender during the course of the infection. Most of the time, they will shrink down as the infection resolves. On occasion, enlarged lymph node(s) can become an abscess (collection of pus) which requires intravenous antibiotics and surgery.
Another common neck mass is a cyst, which is filled with fluid. Many cysts in the head and neck are congenital, that is, they have been present since birth. Despite their presence in the neck, an actual lump may not appear until much later in life. In fact, some congenital neck cysts do not get diagnosed until adulthood.
The most common benign neck masses are branchial cleft cysts, thyroglossal duct cysts, epidermoid cysts, dermoid cysts, lymphangiomas, and hemangiomas. These masses can cause a cosmetic deformity, as they bulge out from the neck. In addition, many neck masses cause symptoms, especially if they get infected. For this reason, surgical removal is generally recommended for most neck masses.
Malignant (cancerous) neck masses are a greater concern for patients but are very rare in children. Malignant neck masses tend to grow more quickly than benign ones, and may be tender or non-tender. Sometimes, a malignant neck mass is a cancer arising from one of the structures in the neck such as the thyroid gland or a salivary gland. In other cases, it can be a metastasis (distant spread) from a cancer that started elsewhere in the body. Some cancers (lymphomas) actually arise from a lymph node in the neck.
The physicians at Coastal Ear, Nose and Throat may also order some imaging studies (CT scan, ultrasound, or MRI) to assess the extent of the mass. Depending on the type and severity of the neck mass, your physician may recommend observation, medications, biopsy or surgical excision of the neck mass.
Congenital Neck Masses
Congenital neck masses, such as branchial cleft anomalies (cysts), thyroglossal duct cysts, and cystic hygromas, are a formation of tissues that appears as a soft lump or drainage point on the neck or below the collarbone, most commonly occurring during the first decade of life. These conditions manifest during embryonic development when the tissues in the affected area fail to develop normally.
Treatment of congenital neck masses usually involves surgical removal to reduce the risk of infection and the development of an abscess. Surgery is performed under general anesthesia and involves an incision placed strategically in a natural skin crease to minimize scarring. Some cases can also be treated with antibiotics, or may not require any treatment at all.
The physicians of Coastal Ear, Nose and Throat specialize in the management of congenital neck masses.