FLEX February 2024

Imaging of Pediatric Head and Neck Masses

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Fig. 29. Nasopharyngeal carcinoma. Axial fat-suppressed post-contrast T1 weighted MRI shows a right nasopharyngeal mass with associated erosion of the clivus ( arrow ) and exten sion into the right hypoglossal canals ( arrowhead ).

CT is beneficial for evaluation of osseous erosion and expansion associated with sarcomas and other malignant lesions ( Fig. 28 ).

Nasopharyngeal carcinoma Children often have enlargement of the nasopharyngeal soft tissues due to benign hypertrophy of adenoids. 37 Consequently, pediatric nasopharyngeal carcinoma may not be suspected clinically until late into the disease process. MRI is useful for screening patients with suspected nasopharyngeal carcinoma and has been found to be more sensitive than endoscopy. 38 Nasopharyngeal carcinoma typically appears as an enhancing mass centered in the posterolateral aspect of the nasopharynx

Fig. 30. Neuroblastoma. Coronal contrast-enhanced CT (L) and contrast-enhanced T1-weighted fat-suppressed MRI demonstrate a heterogeneously enhancing solid lower cervical/upper mediastinal soft tissue mass, consistent with neuroblastoma.

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