Head and neck lesions

An 11-month-old asymptomatic boy presents for evaluation. He has been seen by genetics and endocrinology due to a diagnosis of multiple endocrine neoplasia, type 2A. His calcitonin level was normal and a neck ultrasound is normal. He has a ’highest risk" category RET oncogene variant (M918T). The best treatment option is a observation with yearly calcitonin levels and total thyroidectomy before 5 years of age b observation with US and calcitonin levels q 3 months, and total thyroidectomy before 5 years of age c total thyroidectomy d observation with US and calcitonin levels q 3 months, and total thyroidectomy before 3 years of age

[size=6]A 15-year old girl comes to clinic with a new neck mass. On palpation, there is a nodule in the left lobe of the thyroid gland. Thyroid stiluating hormone and T4 are normal. An ultrasound shows a 3.5 cm mass in the left lobe of the thyroid. There are no palpable nodes on physical exam. The fine needle aspiration cytology returns papillary carcinoma. The next step in management of this patient with a thyroid mass should be a left hemithyroidectomy. b total thyroidectomy. c thyroid scan. d radioactive iodine. e computerized tomography with contrast.[/size]

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Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The lower respiratory tract must be free of infection and excessive secretions when decannulation is contemplated. Microlaryngoscopy and bronchoscopy must be performed to reveal any stomal granulations in the trachea or any suprastomal collapse obstructing the lumen, as well as to evaluate the mobility of the vocal cords."

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Basic anatomic differences from an adult neck should be borne in mind. The dome of the pleura extends into the neck and is thus vulnerable to injury. The trachea is pliable and can be difficult to palpate. It can be easily retracted to a great extent with little pull, and care must be taken to distinguish it from the carotid vessels. The paediatric neck is short, so the operative field is confined. Finally, the cricoid can be injured if it is not correctly identified."

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Unlike head and neck teratomas, lymphatic malformations are typically soft and less likely to significantly compress surrounding structures. The prenatal tracheoesophageal displacement index may be useful in predicting the need for surgical airway management at birth."

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[center] Dermoid Cyst (External Angular Dermoid) Excision, how to and Tricks for a Hidden Incision see in next post [/center]

[center]by Dr. Tamer Ashraf Wafa The indication for the procedure was prolonged intubation see video link in second post [/center]

An 18-month old previously healthy girl presents with a 4-wk history of slowly growing left submandibular mass, followed by skin changes.She is afebrile and asymptomatic. No fluctuance or tenderness, but early signs of skin necrosis are seen. Dx & Treatment?

A 14-year old asymptomatic girl presents with a progressively growing right neck mass. Exam and US show a 2.5 cm right thyroid nodule without cervical lymphadenopathy or other findings. FNA shows follicular cells with Hurthle cell metaplasia. What next?

A previously healthy 4-yr old girl presents with a 5-day history of fever and worsening neck pain. Exam shows a left para-median, tender, erythematous, neck mass. Ultrasound is read as “thyroiditis” and a CT scan shows an inflammatory mass with abscess formation emanating from the left thyroid lobe. How would you manage this patient?

A 2-year old girl presents with a 5-day history of a red swollen mass in the right upper neck. She has no neck pain or fever. The mass is soft, fixed, and non-tender. There is no cellulitis. How would you manage her?

[size=20px]A 3-month-old baby has a large microcystic malformation of the neck. The malformation abuts the trachea and bilateral carotid sheaths. The malformation has been enlarging at a rapid pace. Initial management of this lesion should include: A Administration of sirolimus B Administration of alpelisib C Administration of trametinib D Surgical debulking E Drain placement and sclerotherapy [/size]

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Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message Edit: available without restrictions

An otherwise healthy three-year old girl presents to your clinic with a tender, erythematous lower left neck mass that has developed over the past six weeks. She has been treated with clarithromycin and rifampin for two weeks with no improvement. [size=20px]our recommended management of this neck mass is A curettage. B continued antibiotics. C fine needle aspiration biopsy. D incisional biopsy. E complete excision.[/size]

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