Congenital neck masses (先天性頸部腫塊)

Throglossal cyst (甲狀舌管囊腫)

Most common midline neck cyst usually presenting in childhood.

Clinical features:

Painless, unless infected, and moves on protrusion of tongue. Sinus formation may follow previous infection or incomplete excision.

Management:

If a thyroid scan shows functioning tissue elsewhere, then excise with central portion of hyoid bone and tract up to foramen caecum (Sistrunk’s operation).

Branchial cyst and fistula (鰓裂囊腫及瘻管)

Aetiology:

Represent branchial apparatus remnants. The fistula results from persistence of the second pouch and cervical sinus.

Clinical features:

Cysts usually lie deep to the anterior border of sternomastoid, presenting with a painless neck swelling or mimicking a parapharyngeal abscess if infection occurs. A complete branchial fistula has its internal opening in the region of the tonsil and an external opening anterior to sternomastoid. Diagnosis can be confirmed by needle aspiration of cyst contents.

Management:

Excision, with any fistulous tract.

Cystic hygroma (水囊狀淋巴管瘤)

A variety of lymphangioma.

Clinical features:

A soft transilluminable mass usually presenting in the parotid region in the first year of life.

Management:

Excision, which may have to be incomplete because of the diffuse infiltration of soft tissues by the tumour.