Neck Masses
An abnormal lump found in the neck is often referred to as a neck mass. These lumps, which are common in adults, could be a sign of a serious medical condition or they may be completely benign.
Neck Masses Caused By Infection
If a neck mass is caused by an infection, the mass usually disappears within several weeks of the infection resolving. The types of infections usually related to neck masses, include:
- • A viral or bacterial infection
- • Ear or sinus infection
- • Dental infection
- • Strep throat
- • Mumps or other infection of the saliva glands
The two most common causes of cancers of the neck, throat, and mouth are long-term tobacco use and alcohol use. Another increasingly common risk factor is a human papilloma virus (HPV) infection.
Neck Masses Caused By Tumors
Tumors are simply another word for masses or lumps. They can be cancerous or non-cancerous (benign). Adult neck masses related to cancer are most often due to head and neck squamous cell carcinoma (HNSCC). Other benign and cancerous neck masses include:
- Lymphoma
- Benign or cancerous Thyroid gland tumors including goiter
- Skin cancer
- Cancer that has metastasized (spread from another part of the body)
- Thyroglossal duct and other congenital cysts
- Benign or cancerous salivary gland tumors
- Lipomas
- Sebaceous cysts
When To See An ENT Doctor About A Neck Mass
How do you know it’s necessary to have a neck mass evaluated?
If a neck mass lasts longer than three to four weeks and you also have any of the symptoms listed below, you should see your doctor right away for evaluation. Referral to an ENT specialist may also be needed. Symptoms of concern include:
- The mass gets larger
- The mass decreases in size, but does not completely going away
- There is a change in your voice
- Difficulty swallowing or swallowing is painful
- Trouble hearing or ear pain on the same side of the face as the neck mass
- Neck or throat pain
- Unexplained weight loss
- Nasal blockage in one side of the nose
- Difficulty breathing
- Bleeding from nose and oral cavity
- Coughing up blood or excessive nose bleeds
- Skin lesion on the face or scalp that is growing or changing color
- Night sweats or unexplained itching of the body
Diagnosis
To properly diagnose the cause of a neck mass, a physical examination and testing will be needed. The examination process will likely include:
- Review of medical history
- Physical examination of the head and neck
- Endoscopy – A procedure in which a small endoscope is inserted through the nose to examine the nasal passages, the inside of the throat, the voice box, and the opening of the esophagus. If a more detailed examination or biopsy is required, the endoscopy may be performed in an operating room under anesthesia.
- Imaging, including CT, MRI, and/or PET scans
- Biopsy to sample tissue from the neck. Fine needle aspiration biopsy, core biopsy, tissue biopsy (small sampling of the tissue) or open excisional biopsy (complete removal of the mass) are examples of types of biopsies.
Treatment Options
After diagnosis, a treatment plan will be developed. If the neck mass is cancerous, before developing a plan for treatment, the cancer will be staged. This involves identifying as well as possible where the cancer has spread to, if at all. The stage of the cancer is key in selecting the best treatment. Treatment options could include surgery, radiation therapy, chemotherapy, or a combination of these treatments depending on the diagnosis and stage of the disease. Benign masses may also be removed for reasons including potential airway concerns, unsightly appearance, and rapid or continued growth. It is important to note that some neck masses initially found not to be cancerous may later become or be determined to be cancerous. Therefore, follow-up examination and treatment is critical if a neck mass is present and not fully removed.
This article based upon information provided by the American Academy of Otolaryngology-Head & Neck Surgery.
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