Paediatric head and neck pathology includes a variety of lesions, often diagnostically challenging because of their rarity, unusual histology and difficulty in determining if benign or malignant.

The tumours include melanotic neuroectodermal tumour, sialoblastoma, salivary gland anlage tumour, Langerhans cell histiocytosis, cranial fasciitis and teratoma.

The differential diagnosis of cervical lymphadenopathy and masses in the various compartments differs to that in adults.

Lymphomas and rhabdomyosarcomas are the commonest malignancies.

Thyroid and salivary gland neoplasms share histological features with those in adults but differs in their frequency.

The bulk of the pathology however, comprises inflammatory and developmental conditions.

The head and neck region in childhood presents the pathologist with a wide range of lesions, some similar to those encountered in adults, others unique to childhood.

In contrast to adults the majority of head and neck lesions are benign. They fall into three broad categories - developmental, inflammatory and neoplastic.

Age of the patient is very important when considering the differential diagnosis.

Good communication with clinical colleagues is essential for correct diagnosis.