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Pediatric Endocrinology (Expert Forum)
Autoimmune? continued
Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy, affiliated with Vanderbilt Children's Hospital. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.
Autoimmune? continued
by grlsmom3, Oct 27, 2007 11:23AM
My 14 year old daughter has had an unidentifiable mass in her neck since 2005. US showed a 1.4x0.9x1.3 cm inhomogeneous irregular nodular mass deep to the left sternocleidomastoid muscle and adjacent to the left common carotid artery. Suggested lymphadenopathy and CT scan to further investigate. The CT scan revealed multiple inlarged bilateral jugular and cervical lymph nodes especially on the left. The mass is markedly hypervascular and it is superficial to the sternocleidomastoid muscle. May represent a lymphadenopathy or alternatively, a soft tissue hemangioma. Suggests follow up in 3 to 4 weeks for stability or resolution or to exclude lymphproliferateve neoplastic process or hyperplastic lymph nodes. We took her to an oncologist whom reassured us that is was not cancer and the surgeon that assessed her stated he was sure it was only an infected hair follicle. Now 2 years later we are afraid maybe it was something more serious. The mass is still in her neck on the left side and is prominent when she turns her head. It is very irregular feeling and will easily slide around under the skin to a certain extent. We have scheduled her a nuclear medicine scan of the thyroid with uptake and she will be going right after that to be evaluated by a pediatric endocrinologist. Any help is greatly appreciated.
It does not sound like thyroid, the ultrasound, CT scans would have made mention to the thyroid, but it is good to look at that. This is not an endocrine issue and I would recommend that you work with the pediatric surgeon to consider the need for biopsy which will give the definitive diagnosis. An uptake study will look at thyroid function per se, not necessarily look at cancer versus no cancer. The thought is that if there is a nodule identified in a thyroid and the uptake is low as compared to the rest of the gland there is more concern of a suspicious thyroid nodule. But based on your history you have not even described a thyroid problem rather lymph nodes in the neck.
So the uptake study is a thought but working with your surgeon is more important.