A lump in the neck is also called a neck mass. Neck lumps or masses can be large and visible, or they can be very small. Most neck lumps are benign (noncancerous) and not harmful. But a neck lump can also be a sign of a serious condition, such as an... Read more
A lump in the neck is also called a neck mass. Neck lumps or masses can be large and visible, or they can be very small. Most neck lumps are benign (noncancerous) and not harmful. But a neck lump can also be a sign of a serious condition, such as an infection or a cancerous growth.
If you have a neck lump, your doctor should evaluate it promptly. See your doctor right away if you have an unexplained neck mass.
Where does the lump come from?
A lump in the neck can be hard, soft, tender or non-tender. It can be located in the skin (such as a sebaceous cyst or acne) or it can come from tissues and organs within your neck. Where the lump originates plays an important role in determining what it is. Because there are many muscles, tissues, and organs near the neck, there are many places neck lumps can come from, including:
- lymph nodes
- the thyroid gland, which is a small, butterfly-shaped organ below the Adam’s apple
- parathyroid glands, which are four small glands located behind the thyroid gland
- recurrent laryngeal nerves, which enable movement of the vocal cords
- neck muscles
- the trachea, or windpipe
- the larynx, or voice box
- cervical vertebrae
- nerves of the sympathetic and parasympathetic nervous system
- the brachial plexus, which is a series of nerves that supply your upper limbs and trapezius muscle
- salivary glands
- various arteries and veins
Common underlying causes of neck lumps
An enlarged lymph node is the most common cause of a neck lump. Lymph nodes contain cells that help your body fight off infections and attack malignant cells (cancer). When you’re sick, your lymph nodes can become enlarged to help fight the infection. Other common causes of enlarged lymph nodes include:
- ear infections
- sinus infections
- strep throat
- dental infections
- bacterial infections of the scalp
There are other illnesses that can cause a neck lump:
- Autoimmune diseases, cancer, and other disorders of the thyroid gland, such as goiter due to iodine deficiency, can cause enlargement of part or all of your thyroid gland.
- Viruses, like mumps, can make your salivary glands enlarged.
- Injury or torticollis can cause a lump in your neck muscles.
Most neck lumps are benign, but cancer is a possible cause. For adults, the chance that a neck lump is cancerous increases after the age of 50, according to the Cleveland Clinic. Lifestyle choices, such as smoking and drinking, can also have an impact.
Prolonged use of tobacco and alcohol are the two greatest risk factors for cancers of the mouth and throat. Another common risk factor for cancers of the neck, throat, and mouth is a human papilloma virus (HPV) infection. This infection is generally transmitted sexually, and it’s very common. Signs of an HPV infection are now found in two-thirds of all throat cancers, according to the American Cancer Society.
Cancers that show up as a lump in the neck could include:
- cancers of the head and neck tissues
- Hodgkin’s lymphoma
- non-Hodgkin’s lymphoma
- other types of cancer, including lung, skin, throat, and breast cancer
When we think of viruses, we commonly think of the common cold and the flu. However, there are other viruses out there, and many of them can cause a lump in your neck. These include:
A bacterial infection can cause neck and throat problems, leading to inflammation and a neck lump. Many of these may treated with prescription antibiotics. These include:
- atypical mycobacterium, which is a type of bacteria most common in people with compromised immune systems and lung disease
- cat scratch fever
- peritonsillar abscess, which is an abscess on or near the tonsils
- strep throat
Other possible causes
Other symptoms associated with a neck lump
Because a neck lump can be caused by such a variety of conditions and diseases, there can be many other possible related symptoms. Some people will have no symptoms. Others will have some symptoms that are related to the condition that’s causing the neck lump.
If your neck lump is caused by an infection and your lymph nodes are enlarged, you might also have a sore throat, difficulty swallowing, or pain in the ear. If your neck lump is blocking your airway, you might also have trouble breathing or sound hoarse when you speak.
Sometimes people with neck lumps that are caused by cancer have skin changes around the area. They may also have blood or phlegm in their saliva.
What to expect when you visit your doctor
Your doctor will likely want to ask you about your health history, including details on your lifestyle habits and your symptoms. Your doctor will want to know how long you’ve been smoking or drinking and how much you drink and smoke on a daily basis. Your doctor will also want to know when your symptoms started and how severe they are. This will be followed by a physical exam.
During the physical exam, your doctor will carefully examine your scalp, ears, eyes, nose, mouth, throat, and neck. Your doctor will look for any abnormal skin changes and other related symptoms.
How is a neck lump diagnosed?
Your diagnosis will be based on your symptoms, history, and the results of the physical exam. In some cases, your doctor may refer you to an ENT (ear, nose, and throat) specialist for a detailed evaluation of your ears, nose, throat, and sinuses. The ENT specialist may perform an oto-rhino-laryngoscopy. In this procedure, your doctor will use a lighted instrument to see areas of your ears, nose, and throat that aren’t otherwise visible. This evaluation doesn’t require general anesthesia. In other words, you’ll be awake during the procedure.
Your doctor and any specialist may run a variety of tests to determine the cause of your neck lump. A CBC (complete blood count) can be done to evaluate your overall general health and provide insight into a number of possible conditions. For instance, your white blood cell count may be high if you have an infection.
Other possible tests include:
- sinus X-rays
- chest X-ray, which allows your doctor to see if there’s a problem in your lungs, trachea, or chest lymph nodes
- ultrasound of the neck, which is a noninvasive test that uses sound waves to evaluate neck lumps
- MRI of the head and neck, which makes detailed images of the structures in your head and neck
How to treat a neck lump
The type of treatment for a neck lump depends on the underlying cause. Lumps caused by bacterial infections are treated with antibiotics. Treatment options for cancer of the head and neck include surgery, radiation, and chemotherapy.
Early detection is the key to successful treatment of the underlying cause of a neck lump. According to the American Academy of Otolaryngology, most cancers of the head and neck can be cured with few side effects if they’re detected early.
Neck lumps can happen to anyone, and they’re not always signs of something serious. However, it’s important to see your doctor to be sure. Like all illnesses, it’s better to get diagnosed and treated early, especially if your neck lump turns out to be caused by something more serious. If you have a neck lump and you’re concerned, call your doctor.