10 Years of experience in the evaluation and management of pediatric neck masses

The discovery of a cervical mass in children is a situation quite frequently encountered and often represents a diagnostic or therapeutic challenge for the practicing physician. Although approximately 12% to 15% of all neck masses (NMs) in children may be malignant, most commonly these masses are benign. This study included 137 patients aged between 14 months and 18 years old, with the majority (54.01%) of patients being less than five years old. A total of 83 (60.58%) patients were presented with a single NM, with 64 (59.12%) patients having mass located on the midline of the neck. Preoperatively, in addition to laboratory tests, imaging examinations played an important role in diagnostic orientation and determining the therapeutic plan. Among the imaging examinations, ultrasound was the most commonly used, performed in 87 (63.5%) of the patients. The definitive diagnosis was established based on the histopathological examination of the excised specimens. Midline NMs were most frequently thyroglossal duct cysts or dermoid cysts, while lateral NMs were often lymphadenitis or branchial cysts. The aim of this study was to present the experience of 10 years in evaluating cervical masses in the neck area that appeared in children, their possible causes, the methods of investigation (considering the contribution and limitations of each diagnostic method), and the therapeutic approach (since there is no clear standardization of treatment in the literature).