The neck mass. 1. General concepts and congenital causes.

A carefully taken history and thorough physical examination are the first steps in establishing the cause of a neck mass. Location, size, consistency, and mobility of the mass provide clues and are useful for comparison during follow-up. Further studies are ordered on the basis of the impressions gathered from this evaluation. Congenital neck masses can be found in patients of any age. Thyroglossal duct and branchial cleft cysts and fistulas are formed by incomplete obliteration of the thyroglossal duct and branchial clefts during embryonic development. Other congenital causes include lymphangiomas, cystic hygromas, dermoid cysts, and hemangiomas. Laryngoceles are acquired cysts that arise from an anatomic remnant, the laryngeal ventricle. Treatment for these neck masses is nearly always surgical removal.