Head and neck masses can develop from various causes such as enlarged lymph nodes, congenital cysts or tumors. Most neck masses are caused by enlarged lymph nodes. They are typically benign, but they can affect all age groups.
Lymph nodes can become enlarged as a result of a nearby infection such as a cold, a bacterial infection of the lymph nodes or a bacterial infection elsewhere in the body. An infection of the body will cause multiple lymph nodes to enlarge. The most common causes of this type of reaction are mononucleosis (mono), human immunodeficiency virus (HIV), and tuberculosis (TB).
Cancerous masses are more common in older people and these masses are not painful or tender but are hard to the touch. They usually develop from cancer that has spread from the mouth or throat.
Cysts are common in younger people. They are hollow masses, fluid-filled and usually painless unless they become infected.
Head and neck masses should always be evaluated by a doctor such as an ENT specialist. The doctor will try to figure out how long the mass has been there, whether it is painful and if you are at risk for any viral or bacterial infections such as HIV or TB. They will examine the mass itself, check to see if there are sores or growths in the mouth, and if you are experiencing any difficulty swallowing or hoarseness. To rule out cancer, they may need to use endoscopy, imaging, blood tests or biopsy to diagnose the masses.
No treatment is typically needed for a head or neck masses, but some may require medication or radiation depending on the diagnosis. If the results come back and the mass is cancerous, the lump as well as the lymph node may need to be removed.
The type of neck mass varies with the age group.
- Pediatric (0 to 15 years old)
- Inflammatory > Congenital > Neoplastic
- > 90% of pediatric neck masses are benign
- Young Adult (16 to 40 years old)
- Inflammatory > Congenital > Neoplastic (but neoplasm increasing)
- Adult (> 40 years old)
- Neoplasm more common
- If thyroid nodules are excluded
- 80% of adult neck masses are neoplastic
- 80% of those are malignant
- Persistent or changing neck mass
- Voice change
- Growth or sore in mouth
- Spitting up blood
- Swallowing problems
- Persistent ear pain
- If you have these symptoms, you should be evaluated by your doctor
Head and Neck Mass Evaluation:
Complete history and physical examination to obtain accurate diagnosis. Diagnostic testing if indicated:
- Flexible fiberoptic endoscopy to examine nose, nasopharynx, throat and voice box
- CT Scan, MRI or Ultrasound
- Needle Biopsy or Open biopsy if indicated
Head and Neck Mass Treatment Options:
- Treatment depends on the type of mass
Dr. Darryk Barlow is board certified in Otolaryngology – Head & Neck Surgery. We evaluate and manage head and neck masses in both children and adults.
Common surgical procedures that we perform include:
- Biopsy of abnormal lesions of mouth, throat and neck
- Head and neck mass excision
- Removal of thyroid nodules
- Removal of parotid / submandibular gland tumors
Dr. Barlow operates on pediatric and adult patients at:
- Randall Children’s Hospital and Legacy Emanuel Hospital
- Adventist Medical Center
- Providence Milwaukie Hospital
American Academy of Otolaryngology−Head and Neck Surgery. One Prince St., Alexandria, VA 22314-3357, 1-703-836-4444. 2010 AAO-HNS/AAO-HNSF Flint, P. W., C. W. Cummings, et al. (2010). Cummings otolaryngology head & neck surgery. Philadelphia, PA, Mosby/Elsevier: 3 v. (xlii, 2963, cxciv p.).
Call Mt. Hood ENT & Allergy at (503) 257-3204 for more information or to schedule an appointment.