Department of Plastic and Reconstructive Surgery, Institute of Mother and Child Health Care of Serbia "Dr Vukan Cupic", Belgrade, Serbia.
Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
PLoS One. 2021 May 12;16(5):e0251563. doi: 10.1371/journal.pone.0251563. eCollection 2021.
Lateral neck masses (LNM) often present a diagnostic challenge in the practice of pediatric plastic surgeon. The aim of this study is to investigate the clinical and ultrasound (US) characteristics of pediatric LNM in order to make mutual comparison between their entities and enable the most accurate preoperative diagnosis. A cross-sectional study was conducted among 250 pediatric patients treated by surgical excision or sclerotherapy in our institution in the period from July 2009 to June 2019. Lymphatic malformation was the most frequent congenital LNM (60.9%), while reactive or granulomatous lymphadenitis was the most frequent acquired LNM (47%). Congenital anomalies were significantly more often localized in the upper half of the sternocleidomastoid (SCM) muscle region, and had more often soft consistency than acquired ones. Congenital LNM had a 32.37 (3.44-304.63) times higher likelihood of incorrect (p = 0.002) and 5.86 (1.35-25.48) times higher likelihood of undetermined (p = 0.018) than correct US findings, respectively. Acquired LNM were significantly more often localized in the region behind the SCM muscle and more often had solid US appearance in comparison to the congenital ones. Association of the clinical and US findings is very important in determining the most accurate preoperative diagnosis without exposing the children to unnecessary utilizing ionizing radiation or anesthesia. Although they are mostly benign, extreme caution is necessary due to malignancies which were found in 16.4% of all our patients.
颈部侧方肿块（LNM）在小儿整形外科医生的实践中经常带来诊断挑战。本研究旨在探讨小儿 LNM 的临床和超声（US）特征，以便对其实体进行相互比较，并实现最准确的术前诊断。我们对 2009 年 7 月至 2019 年 6 月期间在我院接受手术切除或硬化治疗的 250 名小儿患者进行了横断面研究。淋巴管畸形是最常见的先天性 LNM（60.9%），而反应性或肉芽肿性淋巴结炎是最常见的获得性 LNM（47%）。先天性异常明显更多地位于胸锁乳突肌（SCM）肌肉区域的上半部分，且比获得性异常更常具有柔软的质地。先天性 LNM 具有 32.37 倍（3.44-304.63）的可能性出现不正确（p = 0.002）和 5.86 倍（1.35-25.48）的可能性出现未确定（p = 0.018）的超声结果，分别。与先天性 LNM 相比，获得性 LNM 明显更多地位于 SCM 肌肉后方区域，且具有更常具有实性 US 外观。临床和 US 表现的关联对于确定最准确的术前诊断非常重要，而无需使儿童暴露于不必要的电离辐射或麻醉下。尽管它们大多是良性的，但由于在我们所有患者中发现了 16.4%的恶性肿瘤，因此需要极其小心。
