From the Guidelines
The most common pediatric head and neck malignancies are lymphoma and rhabdomyosarcoma.
Common Malignancies
- Lymphoma: is a type of cancer that affects the immune system and can occur in the head and neck region, including the lymph nodes in the neck.
- Rhabdomyosarcoma: is a type of soft tissue sarcoma that can occur in the head and neck region, including the muscles of the face, neck, and throat. According to the study on neck mass-adenopathy 1, in children who present with neck masses, malignant etiologies such as lymphoma and rhabdomyosarcoma should be considered in the differential diagnosis, in addition to infectious and congenital etiologies.
Diagnostic Considerations
When evaluating a child with a neck mass, it is essential to consider the clinical examination features, such as the onset, change in mass size, fluctuation, fever, overlying skin erythema, or recent trauma, to guide imaging and diagnosis 1.
From the Research
Common Pediatric Head and Neck Malignancies
The most common pediatric head and neck malignancies include:
- Lymphomas, which account for approximately 27% of cases 2 to 43.39% of cases 3
- Neural tumors, including primitive neurectodermal tumors, which account for approximately 23% of cases 2
- Thyroid malignancies, which account for approximately 21% of cases 2
- Soft tissue sarcomas, including rhabdomyosarcoma, which account for approximately 12% of cases 2 to 20.75% of cases 3
- Nasopharyngeal carcinoma, which accounts for approximately 15.09% of cases 3
Characteristics of Pediatric Head and Neck Malignancies
- These malignancies are rare, representing approximately 5% of all childhood malignancies 4 to 12% of all pediatric malignancies 2
- The incidence of these tumors is approximately 1.49 cases per 1,000 person-years 2
- Malignancy should always be considered in the differential diagnosis of masses in the head and neck region in children 3
- The management strategy for these malignancies has been based largely on the experience in adults, despite the differences between the diseases in children and adults 5
Diagnosis and Management
- Early recognition of malignancy is of obvious importance, and the otolaryngologist may be the first physician to see these children 6
- A combination of translational research from tumor biology studies, multicenter clinical trials, and smaller case series and case reports will continue to guide new advances in diagnosis and treatment 6
- A thorough history and physical examination, as well as a working knowledge of lesions within the head and neck region, are essential for facilitating an appropriate workup and establishing a diagnosis 4