Symptoms of Lump in the Neck

Lumps in the neck are common and it is crucial that every neck lump is evaluated thoroughly to determine the cause of the lump.

In children, teenagers and young adults (< 20 years of age), the most common causes of a neck lump, in order, are inflammation/infection, congenital masses (developmental abnormalities), and then neoplasms (the medical term for tumours). Benign tumours are more common than malignant tumours (cancer).

In adults between the age of 20 to 40 years, the most common causes of a neck lump, in order, are inflammation/infection, benign tumours, congenital masses (developmental abnormalities), and then malignant tumours (cancer).

In adults over the age 40 years, the most common causes of a neck lump, in order, are malignant tumours (cancer), benign tumours, inflammation/infection, and then congenital masses (developmental abnormalities).

Around the world, there is an epidemic of Head and Neck Cancer caused by infection with the Human Papilloma Virus (HPV). The most common presenting symptoms of HPV related cancer of the throat (either in the tonsil or in  the back of the tongue) is a lump in the neck. This means that it is crucial to have any neck lump assessed by a Head & Neck Surgeon as soon as possible.

How do we evaluate neck lumps?

People with neck lumps are evaluated by taking a thorough medical history and by performing an examination of the neck and the upper airway, including endoscopy. Standard endoscopy of the upper airwayis called laryngoscopy, in which an endoscope (a slim tube with a camera on the end)is passed through the noseusing local anaesthetic to examine the airway. A biopsy (a sample of tissue) is performed if any unusual masses or ulcers are found. This may be performed in the office using local anaesthetic, however in many cases this biopsy is performed under general anaesthetic in the operating room.

A biopsy of the neck lump may be required also by performing a fine needle aspirate (FNA), in which a fine bore needle is inserted into the lump to take a sample of cells for inspection by a pathologist.

Additional investigations such as CT scanning, MRI scanning and/or PET-CT scanning may be required to complete the evaluation.

Treatment of the lump is planned according to the results of the investigations completed during the evaluation.