Neck Mass Removal

What is a pediatric neck mass?

A neck mass is a bump or swelling in your child’s neck. Some neck masses are present at birth and are called congenital neck masses. 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. Most neck masses are not cancer (benign). Cancerous (malignant) neck masses are rare in children, but they can occur.

What causes pediatric neck masses?

Neck masses typically fall into one of three categories:

• Infection (lymphadenitis) – This is a swelling or infection of one or more lymph nodes. Lymph nodes are structures in the body and are part of the immune system. They are found all over the body and can vary in size, often growing larger during times of infection. Sometimes the lymph nodes become infected and fluid or pus forms that needs to be surgically drained. After drainage, the wound is usually packed with gauze that is removed slowly over the next day or two. This helps the body heal from the inside to the outside, preventing the infection from coming back.
• Congenital neck masses – These are lumps and bumps that have been present since birth. Sometimes they don’t appear until later in life; however, they can still be consider congenital as many are first noticed when they fill with fluid or become infected – but they were actually there the whole time! There are different types of cysts and your doctor will probably have a good idea based on the location, size, and squishiness of the mass.
• Neoplasms or tumors – Fortunately, these are rare in children. Your doctor may recommend sampling a small piece of tissue with a needle or with surgery (biopsy) to figure out what the tumor is. Medical testsmight include an ultrasound, CT scan, or an MRI scan. After these initial tests to help find the type of tumor, your team of doctors will help you and your child make a treatment plan.

How is a neck mass removal performed?

Depending on the type of neck mass your surgeon will make a cut in the skin and remove the neck mass. Normal muscles, nerves, and blood vessels are usually not harmed. Once the neck mass is removed, it is sent to a pathologist who examines it under the microscope to make sure we know exactly what it is.

How is my child’s neck mass diagnosed?

A diagnosis often requires medical tests and sometimes a biopsy. Your doctor may use ultrasound, a CT scan, or an MRI scan. Sometimes special dyes, called contrast, are injected during imaging to help your surgeon understand where the borders of the tumor are. This can be helpful in making a diagnosis and a plan for surgery. Sometimes before deciding to remove a tumor, a needle sample of the tissue is needed.

Are there any instructions I need to follow before surgery?

Your child must have a physical examination by his or her pediatrician or family doctor within 30 days before surgery to make sure he or she is in good health. The doctor you see needs to complete the History and Physical form provided by our office. You must bring the completed form with you the day of surgery. For your child's safety, it is very important that he or she have an empty stomach when anesthesia is given. Please follow Children’s Hospitals’ Eating and Drinking Guidelines. If you do not follow these guidelines, your child's surgery will be cancelled.

What can I expect after surgery?

The procedure itself will vary in time depending on the size and location of the mass. Your child will wake up in the recovery room after surgery. When your child is awake, he or she will be taken to the discharge area to complete the recovery. You can be with your child once he or she has been transferred to the discharge area.

Your child may have a small dressing or surgical glue over the incision. Most of the time self-dissolving stitches are used so stitches do not need to be removed later. Your surgeon will discuss when the dressings can be removed but this is typically 24 to 48 hours after surgery. If packing or a surgical drain was inserted this will be removed by the surgeon over the next day or two. Pain is typically treated with Tylenol® (acetaminophen) or Children's Motrin® (ibuprofen) but sometimes stronger pain medicines are prescribed. Please let us know if your child develops a fever after surgery or if any redness or drainage comes from the incision site. Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0F that do not come down with Tylenol® (acetaminophen) or Children's Motrin® (ibuprofen).

Questions?

The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician. If you have any questions, please call your Ear, Nose, and Throat clinic.

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