Differential Diagnostics of Expansive Processes at the Child Age in ORL Area


Authors: D. Janeček;  K. Bartoňková;  E. Vogazianos;  I. Šlapák
Authors‘ workplace: Klinika dětské otorinolaryngologie LF MUa FN, Brno přednosta prof. MUDr. I. Šlapák, CSc.
Published in: Otorinolaryng. a Foniat. /Prague/, 57, 2008, No. 2, pp. 59-64.
Category: Original Papers

Overview

From the differential diagnosis point of view, in addition to malignant and benign tumors at the child age, we have to consider also the occurrence of inborn malformations, paraneoplastic processes and vascular anomalies of head and neck. Most formations are of benign character. Malignant tumors include especially sarcomas, less often carcinomas. Most frequent malignity of head and neck in children is RMS and lymphomas. A high volume, tissue infiltration and painless palpation suggest malignity, whereas fluctuation, reddening and palpation sensitivity indicates inflammatory swelling. The affection of ear and temporal bone forms a very low percentage of children head and neck tumors (1.5% of primary tumors). Tumors at the middle floor and rhinobasis include especially parameningeal rhabdomyosarcoma, angiofibroma and rarely carcinoma. Tumors of oral cavity and pharynx are rare in children, and benign ones form 90% of them. Vascular tumors occur only below 6 years of age, odontogenic tumors are present in older children.

At the Clinic of Children Otorhinolaryngology, Teaching Hospital, Brno, 143 patients have been operated on in the years 2002-2006. In these patients, diagnoses and results of histological examination have been related to individual anatomical regions. Occasional re-operations are not included. Malignant head and neck tumors have been very rare and their symptoms were often not characteristic. Most of these tumors were of mesenchymal origin with a fast and destructive growth. In comparison with the statistics of adult patients, the incidence of children tumors in the head and neck region are significantly lower. There is also a principal difference in histology. Whereas in the adult patients epithelial tumors (carcinomas) prevail, these are in children and mostly benign cystic formations and vascular anomalies occur. Among malignant tumors most frequent are mesenchymal ones – lymphomas and sarcomas (rhabdomyosarcoma). Although children suffer more often from non-Hodgkin lymphomas, they encounter more frequently Hodgkin lymphoma in the head and neck region. In the therapy of malignant tumors at the child age, interdisciplinary cooperation and individual approach proved to be very important.

Key words:
tumors of older children, malignant tumor sof of head and neck, differential diagnosis.


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Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)
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