title: Neck epidermoid cyst mimicking tuberculosis at ultrasound: Case report and review of literature.
abstract: Neck masses in children can be inflammatory, congenital or neoplastic. When a congenital cyst becomes infected repeatedly, it may mimic inflammatory disease and the diagnosis may be challenging with ultrasound. An increasing incidence of infection with non-tuberculous mycobacterial organisms has been observed in recent decades in children with cervical lymphadenopathy. An ultrasound scan performed during the infectious phase of a mass can be misleading and can lead to an incorrect diagnostic hypothesis with the risk of erroneous medical and surgical therapies. We describe a case of a lateral neck epidermoid cyst mimicking and misdiagnosed as a tuberculous lymphadenopathy at ultrasound scan and treated with primary surgical excision. After surgery, a histological diagnosis of an epidermal cyst was made. There were no signs of recurrence during the 12-month follow-up period. A review of the literature and a proposed practice pathway for lateral cervical lymphadenopathy in children is also reported.
authors.affiliation: Department of ENT, University of Siena, Siena, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Cambi
authors.affiliation: Department of ENT, University of Siena, Siena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Monciatti
authors.affiliation: Department of Diagnostic Radiology, University of Siena, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pelliccia
authors.affiliation: Department of ENT, University of Siena, Siena, Italy.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Spinosi
authors.affiliation: Department of ENT, University of Siena, Siena, Italy.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Brindisi
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D004814:Epidermal Cyst / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis; D008297:Male; D009333:Neck / Q000473:pathology; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*; D014463:Ultrasonography
keywords: child; epidermoid cyst; lymphadenopathy; neck; tuberculosis; ultrasound