Introduction

Neck mass is a common discomfort in otolaryngology. Many people visit doctors due to worry about malignancy, because they note that painful / painless neck mass accidentally. 

Generally, neck mass is often associated with head and neck disease. Therefore, if you have neck mass, please visiting ear, nose and throat specialist first.

Etiology

1. Congenital mass: such as thyroglossalduct cyst, branchial cleft cyst, and dermoid cyst, teratoma
2. Inflammatory mass: such as lymphadenitis, sialoadenitis, Mycobacterium tuberculosis infection, cat-scratch fever, and deep neck infection
3. Neoplasm:

• Malignancy tumor: such as lymphoma, sarcoma, thyroid cancer, salivary gland cancer, nasopharyngeal cancer, oral cavity cancer, oropharyngeal cancer, laryngeal cancer, hypopharyngeal cancer with neck metastasis, even chest or abdomen malignancy with neck metastasis.
• Benign tumor: such as angioma, salivary gland tumor, lymphangioma, neurofibroma, carotid body tumor, and neurolemmoma.

Symptoms

Neck painful/painless mass may bring other symptoms such as fever, body weight loss, aural fullness, blood-tinged sputum, painful swallow, and voice change.

Diagnosis tools

Detailed history taking and endoscopic examination to check nasal cavity, oral cavity, oropharynx, larynx and hypopharynx carefully are necessary. Further needle aspiration cytology examination, head and neck CT scan, head and neck MRI or biopsy of suspicious tissue at upper aerodigestive tract will be arranged if it is indicated.

Treatment

If neck mass had been proved lymphadenitis only, oral intake of antibiotics plus regular clinic follow up is enough. If it is caused by salivary gland tumor or benign cystic lesion, surgical excision with pathologic diagnosis is to take into account. If malignancy is suspected, further detailed examinations to find original pathology is necessary.

Prevention

Most neck mass is related to benign lymph nodes hyperplasia or inflammatory lymphadenitis. But people with high risk of carcinogen exposure such as smoking or betel quid chewing should quit them quickly. And if there are symptoms like fever, body weight loss, oral/ nasal bloody discharge, middle ear effusion, persisted sore throat or hoarseness, visit E.N.T. doctors for professional evaluation as soon as possible.