FIGURE 48.2 Differential diagnosis of neck mass by location Area Parotid: cystic hygroma, hemangioma, lymphadenitis, parotitis, Sjögren and Caffey–Silverman syndrome, lymphoma Area Postauricular: lymphadenitis, branchial cleft cyst (1st), squamous epithelial cyst Area Submental: lymphadenitis, cystic hygroma, sialadenitis, tumor, cystic fibrosis Area Submandibular: lymphadenitis, cystic hygroma, sialadenitis, tumor, cystic fibrosis Area Jugulodigastric: lymphadenitis, squamous epithelial cyst, branchial cleft cyst (1st), parotid tumor, normal—transverse process C2, styloid process Area Midline neck: lymphadenitis, thyroglossal duct cyst, dermoid, laryngocele, normal—hyoid, thyroid Area Sternocleidomastoid (anterior): lymphadenitis, branchial cleft cyst (2nd, 3rd), pilomatrixoma, rare tumors Area Spinal accessory: lymphadenitis, lymphoma, metastasis (from nasopharynx) Area Paratracheal: thyroid, parathyroid, esophageal diverticulum Area 10 Supraclavicular: cystic hygroma, lipoma, lymphoma, metastasis, normal—fat pad, pneumatocele of upper lobe Area 11 Suprasternal: thyroid, lipoma, dermoid, thymus, mediastinal mass (From May M Neck masses in children: diagnosis and treatment Pediatr Ann 1976;5(8):517–535 Reprinted by permission.) Thoracoabdominal examination should pay special attention to auscultation and consideration for other signs of systemic illness Extrathoracic compression of the upper airway may manifest only as faint inspiratory stridor A goiter may be coupled with signs of thyroid hormone excess (e.g., tachycardia, bounding