Lumps And Bumps Of The Neck In Children – Imaging Approach To Pediatric Congenital And Acquired Neck Lesions

Abstract

Rotterdam, Rotterdam, The Netherlands Neck masses present as palpable lumps and bumps in children. Acquired lesions are more common than congenital ones. Congenital masses (lumps and bumps) of the neck are by definition present at birth. Despite the congenital origin of this type of lesions, some of these may not be clinically present until later in life. The etiology of congenital neck masses varies from developmental anomalies to vascular, inflammatory and tumoral lesions. Many of the neck masses seen in children are acquired lesions. These acquired lumps are most often benign however rarely can be malignant in children. The etiology is inflammatory, vascular, neoplastic, or of traumatic origin. Mass lesion of the neck are often identified as bumps on physical examination. Imaging plays an essential role in the characterization and final diagnosis of the various entities. A systematic imaging approach to masses of the neck helps to narrow down the differential diagnosis. This approach includes determining the primary site of origin, involvement of and extension across the various anatomic spaces of the neck, to evaluate the normal contents of the involved anatomic space and to assess the characteristic imaging features of the lesion. The age of the patient and the clinical presentation are also important factors and often characteristic for the type of lesion, and should consequently be taken into account during the interpretation of the imaging studies. The correct final diagnosis is essential to determine the proper treatment strategy. Ultrasonography (US) and MR imaging are the primary imaging modalities of choice for many congenital neck lesions in the pediatric population. The use of CT should be limited in children because of the potential long term risks of ionizing radiation in this vulnerable patient group. The objective is to identify the characteristic location and imaging features, differential diagnosis and differentiating features of the most frequent congenital and acquired cervical mass lesions (lumps and bumps) in the pediatric population.