Neck masses are common problems in infants and children. Some neck masses are congenital (present at birth) and result from abnormal formation during embryonic development. Many neck masses appear with an upper respiratory infection such as a cold or sinus infection. Some are not found until they become enlarged and painful from infection.
Although a neck mass can involve other structures in the head and neck area, most are benign (non-cancerous). Cancerous neck masses are rare in young infants and children, but occasionally a mass is diagnosed as Hodgkin’s or non-Hodgkin’s lymphoma—both cancers of the lymphatic system. Even more rare are malignancies such as sarcoma located in the neck.
Your child’s physician will consider many factors when diagnosing a neck mass, including the following:
- The age of child
- How long the mass has been present, and whether other masses are present
- Family history of masses
- Any prior or ongoing illnesses, ear infections, and/or animal bites
Examination of neck masses may include the following:
- Careful visualization and palpation (feeling with the fingers) of the child’s neck
- Identifying the specific location of the mass
- Checking for movement of the neck and the mass itself
- Observing for swelling, redness, warmth, tenderness, drainage, or fluid in the mass
Further tests may be needed to completely diagnose the type of neck mass and whether other tissues and structures in the neck are involved. Treating neck masses depends on the type of mass and whether there is infection. Often, surgical removal of the mass is needed.
The lymphatic system
Neck masses in children often involve the lymphatic system, which is part of the immune system and functions to fight disease and infections.
The lymphatic system goes through many changes throughout a child’s growth and development. Before birth, a fetus relies on the mother’s immune system for protection from infections. At birth, a newborn’s lymphatic system begins to respond to the frequent exposure to new antigens (organisms and diseases). Lymphatic tissue grows steadily until puberty, when growth slows.
The lymphatic system includes the following:
- Lymph: fluid containing lymphocyte cells.
- Lymph vessels: thin tubes that carry lymph fluid throughout the body.
- Lymphocytes: white blood cells that fight infection and disease.
- Lymph nodes: bean-shaped organs, found in the underarm, groin, neck, chest, and abdomen, that act as filters for the lymph fluid as it circulates through the body.
Children are constantly fighting off new germs and infections and their lymphatic system quickly responds to these antigens. Because of this response, it is quite common for children to have slightly enlarged lymph nodes in certain areas of the body some of the time. However, changes in the lymph nodes can also indicate certain conditions or diseases that need special treatment. Always consult your child’s physician for questions or concerns about any mass you notice in your child.