A congenital neck mass is a growth at birth that eventually becomes noticeable to the patient and family. Although the neck abnormality is present at birth, a lump may not appear till much later in life. The most common congenital neck masses are the branchial cleft anomalies, thyroglossal duct cysts, lymphangiomas, hemangiomas and dermoid cysts.
The branchial cleft cyst or tracts are due to trapped tissue in the developing neck. They appear as a soft lump or draining opening in the side of the neck in the first years of life. There are 3 types of branchial cysts depending on the anatomy and its relationship to the adjacent blood vessels and nerves. A C.T. scan can allow the doctor to identify the exact location of these cysts. Surgical removal is advised since these cysts can get infected or become abscessed which would require a drainage procedure before definitive removal.
Thyroglossal duct cysts are remnants of the thyroid gland migration from the base of tongue into the neck in utero. These cysts show up from childhood to adulthood as a soft, nonpainful lump in the midline of the upper neck. Because thyroid tissue may be inside the cyst, it is important that an ultrasound or thyroid scan be done to the mass is not undesended functioning thyroid gland. Surgical removal is recommended before these cysts become infected.
Lymphangiomas are the result of an abnormal collection of lymph channels in the body. Extensive collections of fluids from these channels from cysts known as lymphangioas or cystic hygromas. These cysts are not cancerous but by there invasive growth can cause significant cosmetic deformity. These lesions are evaluated by examination and M.R.I. imaging. Sclerosing agents injected into these cysts can help reduce the size by scarring the channels followed by surgical removal which can be extensive.
Hemangiomas are bulging bluish-red masses protruding from the facial are and sometimes involving the breathing tube below the voice box. Hemangiomas start growth shortly after birth and reach a peak at 2 years of age. They start to shrink over the next several years. Magnetic resonance imaging (M.R.I.) is used to diagnose this tumor. Steroids may be given in severe situations or surgical intervention utilizing laser technology utilized if spontaneous resolution does not occur.
Dermoid cyst is a mass containing skin elements (hair, skin and skin glands) trapped under the skin usually located in an imaginary line form the middle of the forehead straight down to the lower neck. It is a painless swelling in the midline face that is evaluate by C.T. or M.R.I. scans to access any extention from the forehead or nose into the skull bone. Surgical treatment may be simple unless the skull bone show evidence of the tumors whereby a neurosurgeon is consulted.