What Is a Pediatric Neck Mass?
A neck mass is a lump, bump, or swelling in the neck. They're common in children.
Some neck masses are present at birth (congenital neck masses) due to abnormal formation during the early stages of pregnancy.
Most neck masses are benign (not cancer). Cancerous neck masses are rare in children, but they can occur.
Doctors can find neck masses by sight or touch. Many first appear during an upper airway infection like a cold.
Some neck masses grow quickly and cause pain. Others grow slowly and do not cause pain.
What Causes Neck Masses in Children?
Neck masses in children can occur because of problems forming the structures in the neck during:
- Early stages of development in the womb.
- Infections.
- Occasional hormone defects.
- Cancer, but rarely.
Before your child's next doctor visit, you should note:
- Your child’s age.
- How long the neck mass has been present.
- Any changes in size, color, firmness, or drainage.
- Your child’s and family’s current or past health problems.
- Any recent travel or exposure to animals.
You'll want to share and discuss these notes with your doctor during your child's visit.
How Do You Diagnose My Child’s Neck Mass?
ENT doctors at UPMC Children’s Hospital of Pittsburgh will go through your child's medical history and do a thorough exam. Sometimes, bloodwork or imaging tests can help diagnose your child's neck mass.
If your child has had any tests before you visit, please provide results to your doctor.
What Are the Most Common Types of Pediatric Neck Masses?
Common types of neck masses fall under these main groups:
- Present at birth
- Infectious
- Other, such as cancer and thyroid masses
Neck masses present at birth
Thyroglossal duct cysts (TGDCs)
TGDCs are the most common type of neck mass present at birth.
You can see or feel TGDCs early in children, but may not notice them until they become infected. Infected cysts can be red, warm, painful, and cause a fever.
These common neck masses have mucous-like fluid and often connect to the:
- Deep part of the tongue
- Hyoid (structure in middle part of the neck)
- Thyroid
TGDCs can cause thyroid cancer, but this is rare.
Treatment normally involves surgery of the cyst, hyoid, and tract.
Branchial cleft cysts (sinus tracts)
Branchial cleft neck masses:
- Can be cysts (fluid-filled pouches) or sinuses (opening(s) to the skin, throat, or both).
- Occur when structures in the neck fail to form normally.
- Can form on either or both sides of the neck.
- Are not cancerous, but can get infected repeatedly.
Dermoid cysts
Dermoid cysts:
- Are pockets or sacs under the skin that contain tissues normally present in the skin.
- Can occur at birth, early infancy, or later.
- Are not cancerous, but can grow and sometimes become infected.
Fibromatosis colli (sternocleidomastoid muscle tumor of infancy)
This type of neck mass is:
- The most common neck mass in infants.
- Often seen at two to four weeks of age.
- A benign (not cancer) mass inside the large angled muscles on both sides of the neck).
Doctors treat this neck mass with physical therapy.
Normal neck structures
These include:
- Salivary gland (spit glands)
- Throat cartilage or bone
- Tendons that connect muscles to bone or cartilage
You seldom see or feel these normal neck masses.
Infectious neck masses
Lymphadenitis
This lymph node infection:
- Is the most common cause of neck mass in children.
- Occurs when lymph nodes (structures that help filter and fight infections) become enlarged, often in response to bacteria or viruses.
- Can sometimes cause the lymph nodes to become abscesses (pus-filled sacs).
Sialadenitis
This salivary gland infection:
- Can cause neck masses in children.
- Occurs when viruses and bacteria cause the salivary glands (spit glands) under the chin or in the cheek to swell and ache.
UPMC is a leader in salivary endoscopy.
Other masses
Cancers
Thyroiditis and thyroid masses:
- Thyroiditis is a painful swelling of the thyroid gland.
- Thyroid nodules are lumps in the thyroid gland at the base of the neck. They're seldom cancerous.
- We work with the Pediatric Thyroid Center at UPMC Children’s Hospital.
How Do Doctors Treat Pediatric Neck Masses?
Treatment depends on the type of neck mass. Doctors may decide to observe your child’s mass, while other types of masses may need more testing or surgery.
We'll discuss your treatment options with you after your child's exam at UPMC Children’s.
Contact UPMC Children's About Pediatric Neck Mass Services
Call us at 412-692-5460 to learn more about our pediatric neck masses services.
