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Neck masses in children

L Roth, S Moerdler, D Weiser, L Douglas, J Gill, M Roth
OBJECTIVE: To determine how otolaryngologists and pediatric oncologists differ in their initial approach to diagnosing head and neck masses in children and adolescents. METHODS: We designed an electronic 28-question survey consisting of 4 clinical cases and one referral case varying by patient age, history, and physical exam findings. The survey was sent anonymously to pediatric oncologists and otolaryngologists at institutions in the United States and Canada. RESULTS: Two hundred and thirty one pediatric oncologists (29...
March 7, 2019: International Journal of Pediatric Otorhinolaryngology
Zhibao Lv, Xiaoling Bai, Qingfeng Sheng, Jiangbin Liu, Yibo Wu
RATIONALE: Teratomas are extremely rare in the thyroid gland. A cervical teratoma presenting as a cystic or mixed thyroid lesion can be easily confused with a thyroglossal duct cyst. It is difficult for pediatricians to differentiate between these 2 types of lesions. PATIENTS CONCERNS: A 2-year-old girl who presented a growing thyroid mass for 14 months showed a mass in her left thyroid lobe under contrast-enhanced computed tomography (CT). DIAGNOSIS AND INTERVENTIONS: Ultrasonography found a mass of 5 × 3...
March 2019: Medicine (Baltimore)
Melis Demirag Evman, Hakan Avci, Sedat Aydin
Cervical lymphangiomas are benign congenital malformations of lymphatic system usually seen in children under 2 years of age. It is rare in adults. They can be seen in any part of the body but the most common area in the neck region is posterior triangle. They usually present as asymptomatic masses. There are various ways of treatment, but the most common treatment modality is surgical resection. Here, the authors present a giant lymphangioma in the neck region of an adult who is treated with surgical resection without any complication...
February 21, 2019: Journal of Craniofacial Surgery
Scott A McAninch, Jared W Glenn, Kellie Quinn, Jacob K Barney
We present an unusual case of a 6-year-old boy who presented with the sudden presence of left neck mass and acute hypoxemic respiratory failure, whose subsequent imaging demonstrated a previously undiagnosed anterior mediastinal mass (AMM) extending into the left neck. Biopsy of the mass was consistent with a desmoid tumor, which is a rare cause of AMM in children. Desmoid tumors are locally aggressive, often invading and enveloping surrounding tissues, but overall slow growing. The sudden growth of the neck mass suggests a very aggressive desmoid tumor, causing an unexpected respiratory compromise...
February 20, 2019: Pediatric Emergency Care
Olja Grgic, Fernando Rivadeneira, Enisa Shevroja, Katerina Trajanoska, Vincent W V Jaddoe, Andre G Uitterlinden, Thomas J Beck, Eppo B Wolvius, Carolina Medina-Gomez
Bone modeling is an important process in the growing skeleton. An inadequate bone modeling in response to mechanical loads would lead some children to develop weaker bones than others. The resulting higher stresses in the bones would render them more susceptible to fracture. We aimed to examine the association between femoral stress (FS) derived from structural parameters and BMD in relation to incident fractures in children. Bone stress was evaluated at the medial femoral neck, a skeletal site subject to large forces during normal locomotion...
February 21, 2019: Bone
Natasha D Dombrowski, Nikolaus E Wolter, Alexandria L Irace, Michael J Cunningham, Jennifer W Mack, Karen J Marcus, Sara O Vargas, Antonio R Perez-Atayde, Caroline D Robson, Reza Rahbar
INTRODUCTION: Mucoepidermoid carcinoma is a rare malignant salivary gland neoplasm in the pediatric population. Few studies have discussed best practice with respect to diagnosis and treatment in children. OBJECTIVE: To present our institution's experience with the evaluation and management of pediatric mucoepidermoid carcinoma of the head and neck. METHODS: Retrospective chart review of patients under 20 years of age diagnosed with mucoepidermoid carcinoma of the head and neck between 1998 and 2017...
February 10, 2019: International Journal of Pediatric Otorhinolaryngology
Philip A Sosa, Phillip Matar, Isabel T Gross
BACKGROUND: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. CASE: A 10-year-old boy presented to the emergency department with complaints of a neck mass and residual cough from a recent upper respiratory infection...
March 2019: Pediatric Emergency Care
Hilary Pitner, Charles Elmaraghy, Beth Fischer, Amanda Onwuka, Andrew Rabe, Patrick Walz
OBJECTIVE: To assess clinical evaluation, ultrasound, and previously published predictive score at preoperatively diagnosing midline neck masses and demographic or clinical associations that aid in differentiation of thyroglossal duct and dermoid cysts. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care children's hospital. SUBJECTS: Patients <18 years undergoing primary midline neck mass surgery with histopathologic diagnosis of thyroglossal duct or dermoid cyst who had preoperative ultrasound performed were included...
February 5, 2019: Otolaryngology—Head and Neck Surgery
Giuseppe Riva, Matteo Sensini, Federica Peradotto, Carlo Scolfaro, Gianpaolo Di Rosa, Paolo Tavormina
Pediatric neck masses are a common occurrence and often represent a diagnostic challenge. The primary aim of this retrospective study was to evaluate the clinical and radiological features of neck masses in children and how they can drive diagnosis. The secondary aim was to create a diagnostic algorithm based on clinical features. We evaluated 190 children with neck masses who needed hospitalization. Clinical data and imaging findings were collected. The patients were divided into six groups: congenital/developmental lesions, tumors, acute and subacute lymphadenopathies, chronic nonspecific lymphadenopathies, cat-scratch disease, and mycobacteriosis...
January 14, 2019: European Journal of Pediatrics
Khaled Elshaar, Laila AbuAleid
Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in children younger than two years of age. Hygroma commonly presents in head and neck but can be present anywhere. It is rarely seen in adults. We report the case of a 28-year-old woman who presented with a huge painless right-sided cystic neck swelling of 11 months duration, associated with progressive dysphagia and difficulty in breathing when lying supine or on her left side. Clinically, the swelling occupied both right anterior and posterior triangles of her neck with impalpable right carotid pulsations...
January 3, 2019: Annals of the Royal College of Surgeons of England
Yuan Cao, Shuang Wu, Liyu Zhang, Ying Yang, Sancheng Cao, Qiao Li
BACKGROUND: The co-existence of allergic rhinitis (AR) and obstructive sleep apnea (OSA) is a common phenomenon in clinical practice. AR has long been considered a risk factor for OSA. However, the relationship is not completely clear. Therefore, we conducted a meta-analysis to evaluate the prevalence of AR in sleep-disordered breathing (SDB) /OSA and their relationship. METHODS: A comprehensive literature search was performed in PubMed/Medline, Google Scholar, Wiley Online Library, EMBASE, and Web of Science...
December 2018: Medicine (Baltimore)
Emily Savoca, Saral Mehra, Erik H Waldman
Cervicofacial actinomyces is an uncommon infection, especially in children. Notoriously low culture sensitivity and malignant appearance make diagnosis challenging. Treatment requires a prolonged antibiotic course often in conjunction with surgical debridement or drainage. We report an amorphous anterior neck mass in a 10-year-old girl due to actinomyces. Diagnosis required open biopsy after non-diagnostic fine needle aspirate and core needle biopsies. The patient responded well to six-week course of parenteral penicillin followed by six months of convalescent therapy with oral penicillin...
January 2019: International Journal of Pediatric Otorhinolaryngology
Manish Kuchakulla, Ashish H Shah, Valerie Armstrong, Sarah Jernigan, Sanjiv Bhatia, Toba N Niazi
OBJECTIVECarotid body tumors (CBTs), extraadrenal paragangliomas, are extremely rare neoplasms in children that often require multimodal surgical treatment, including preoperative anesthesia workup, embolization, and resection. With only a few cases reported in the pediatric literature, treatment paradigms and surgical morbidity are loosely defined, especially when carotid artery infiltration is noted. Here, the authors report two cases of pediatric CBT and provide the results of a systematic review of the literature...
December 1, 2018: Journal of Neurosurgery. Pediatrics
Monika Obara-Moszynska, Justyna Rajewska-Tabor, Szymon Rozmiarek, Katarzyna Karmelita-Katulska, Anna Kociemba, Barbara Rabska-Pietrzak, Magdalena Janus, Andrzej Siniawski, Bartlomiej Mrozinski, Agnieszka Graczyk-Szuster, Marek Niedziela, Malgorzata Pyda
Cardiovascular defects occur in 50% of patients with Turner syndrome (TS). The aim of the study was to estimate the usefulness of cardiac magnetic resonance imaging (CMR) and magnetic resonance angiography (angio-MR) as diagnostics in children and adolescents with TS. Forty-one females with TS, aged 13.9 ± 2.2 years, were studied. CMR was performed in 39 patients and angio-MR in 36. Echocardiography was performed in all patients. The most frequent anomalies diagnosed on CMR and angio-MR were as follows: elongation of the ascending aorta (AA) and aortic arch, present in 16 patients (45...
2018: Frontiers in Endocrinology
Ya Xu, Ting Zhou, Wendong Yu, Neda Zarrin-Khameh
Alveolar soft part sarcoma is a rare highly malignant neoplasm of the soft tissue and usually occurs in the lower extremities of children and young adults. We report two cases of alveolar soft part sarcoma: a 24-year-old Latino man with a 10-cm neck mass and a 56-year-old Latino woman with a recurring thigh mass. Fine-needle aspiration and a core biopsy were performed on both, which was followed by tumor resection on the man. The smears displayed numerous loosely cohesive or single large cells with abundant granular cytoplasm, round nuclei, vesicular chromatin, and occasional prominent nucleoli...
November 20, 2018: Diagnostic Cytopathology
James Blackburn, Dinesh Giri, Barbara Ciolka, Nicole Gossan, Mohammad Didi, George Kokai, Alison Waghorn, Matthew Jones, Senthil Senniappan
Activating mutations in thyrotropin receptor ( TSHR ) have been previously described in the context of nonautoimmune hyperthyroidism and thyroid adenomas. We describe, for the first time, a mutation in TSHR contributing to follicular thyroid carcinoma (FTC) in an adolescent. A 12-year-old girl presented with a right-sided neck swelling, increasing in size over the previous four weeks. Clinical examination revealed a firm, nontender thyroid nodule. Ultrasound scan of the thyroid showed a heterogeneous highly vascular mass...
2018: Case Reports in Genetics
Eloy Méndez-Gallegos, Graciela Caire-Juvera, Humberto Astiazarán-García, Rosa O Méndez-Estrada
The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3)...
November 5, 2018: Nutrients
Lourdes Quintanilla-Dieck, Edward B Penn
Congenital neck masses can be a developmental anomaly of cystic, solid, or vascular origin. They can also constitute neoplasms, including malignancies, although this is rare in the pediatric population. The history and examination can help quickly narrow the differential diagnosis. Imaging also plays an essential role in defining the characteristics and likely cause of neck masses. The most common neck masses in young children are thyroglossal duct cysts, branchial cleft anomalies, and dermoid cysts. Also important to consider in the differential diagnosis are solid tumors, such as teratomas, or vascular lesions, such as hemangiomas...
December 2018: Clinics in Perinatology
Marla C Levine, Alexander Arroyo, Antonios Likourezos, Peter Homel, Eitan Dickman
OBJECTIVE: Most soft tissue neck masses represent benign inflammatory or infectious processes; however, in some cases the diagnosis is not clear and a broader differential must be considered. The aim of this study was to compare point-of-care ultrasound (POCUS) to radiology department imaging (RDI) in the diagnosis of soft tissue neck masses. METHODS: This prospective pilot study involved a convenience sample of patients ranging in age from 1 month to 18 years of age presenting to the Pediatric Emergency Department (PED) with a soft tissue neck mass...
October 23, 2018: American Journal of Emergency Medicine
Andrea Kelly, Justine Shults, Sogol Mostoufi-Moab, Shana E McCormack, Virginia A Stallings, Joan I Schall, Heidi J Kalkwarf, Joan M Lappe, Vicente Gilsanz, Sharon E Oberfield, John A Shepherd, Karen K Winer, Mary B Leonard, Babette S Zemel
Annual gains in BMC and areal bone mineral density (aBMD) in children vary with age, pubertal status, height-velocity, and lean body mass accrual (LBM velocity). Evaluating bone accrual in children with bone health-threatening conditions requires consideration of these determinants. The objective of this study was to develop prediction equations for calculating BMC/aBMD velocity SD scores (velocity-Z) and to evaluate bone accrual in youth with health conditions. Bone and body compositions via DXA were obtained for up to six annual intervals in healthy youth (n = 2014) enrolled in the Bone Mineral Density in Childhood Study (BMDCS) ...
October 29, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
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