Correlation between pre-operative diagnosis and post-operative pathology reading in pediatric neck masses—A review of 281 cases. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Gov-Ari, Eliav; Leann Hopewell, Bridget
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 79:Issue 1(2015:Jan.)
• Page Start: 2
• Page End: 7
• Publication Date: 2015-01
• Subjects: Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2014.11.011
• Languages: English
• ISSNs: 0165-5876

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Objective</title> <p id="spar0005">Describe the pre-operative diagnosis correlation of pediatric neck masses with the final post-operative pathology reading. Evaluate if added imaging studies were associated with higher frequency of correct diagnosis.</p> </sec> <sec> <title id="sect0015">Study design</title> <p id="spar0010">Retrospective case series review.</p> </sec> <sec> <title id="sect0020">Setting</title> <p id="spar0015">Tertiary Academic Medical Center.</p> </sec> <sec> <title id="sect0025">Subjects and methods</title> <p id="spar0020">Data was collected from 281 pediatric patients with an undiagnosed neck mass that underwent open biopsy from January 1986 to December 2011. Data collection included pre-operative accuracy and relative contributions of clinical clues and imaging studies.</p> </sec> <sec> <title id="sect0030">Results</title> <p id="spar0025">Pre-operative and post-operative diagnoses match varied for each category of diagnoses. The difference in distribution of correct pre-operative diagnoses between 6 categories of neck masses was statistically significant. The highest number of cases with correct pre-op diagnosis was seen with congenital masses which were correctly diagnosed with 75% of cases (<italic>n</italic> = 109), followed by benign tumors which were diagnosed with 73.7% of cases (<italic>n</italic> = 19). When CT scans were included in the pre-op work up, it was associated with a non-significant trend toward a less frequent correlation between pre and post-operative diagnosis in congenital, nodal inflammatory and miscellaneous masses. However, with regards to the diagnosis of benign tumors, CT scan was associated with a trend toward higher proportion of correct pre-op diagnosis. In cases where US was included in the evaluation, we found a trend toward less frequent correlation with post op diagnosis in benign tumors, nodal inflammatory, non-nodal inflammatory and miscellaneous diagnoses and an increase in accuracy for congenital masses.</p> </sec> <sec> <title id="sect0035">Conclusion</title> <p id="spar0030">Certain types of pediatric neck masses are easy to diagnose likely due to their classic presentation. Failure to diagnose masses often occurs when the clinical picture is vague or non-specific. Ancillary imaging studies do not always correlate with increased accuracy of diagnosis, particularly when the clinical clues are typical.</p> </sec> </abstract>