FIGURE 48.1 Evaluation of the child with a neck mass a Malignancy: nontender, >3 cm diameter (and firm), enlarging mass of several weeks’ duration, ulceration, location deep to superficial fascia or fixed to tissue, supraclavicular mass, systemic lymphadenopathy and bruising, superior vena cava syndrome After obtaining a thorough account of the mass itself, it is critical to assess the involvement of other organ systems Constitutional symptoms of fever, fatigue,