Neck lumps and swellings in children

Abstract

Management of congenital and acquired neck lumps forms a large proportion of surgical interventions performed in childhood. Enlarged cervical lymph nodes are the commonest cervical swellings, and when related to infection these will often resolve spontaneously or with antibiotic treatment. They can, however, be the presentation of malignancy such as lymphoma, which requires biopsy for specific diagnosis to guide treatment. The commonest congenital malformations in the cervical region are thyroglossal duct cysts, which cause a midline cervical swelling that typically becomes apparent in the first few years of life. Remnants of the branchial arches, especially the second branchial arch, result in fistulae, sinuses and cysts. These lesions all require surgical excision to prevent infection of the lesions as well as for cosmesis. Up to 75% of lymphatic malformations occur in the cervical region. These are most commonly a cosmetic problem but can cause significant respiratory symptoms if large and involving the oropharyngeal region.