Neck Mass

Abstract

April 2004

Section 2 Head and Neck

3 Neck Mass

Barry J. Roseman, M.D.
Roseman and Budayr, M.D., P.C., Maryville, Tennessee

Orlo H. Clark, M.D.
Professor, Department of Surgery, University of California, San Francisco, School of Medicine, and Chief, Department of Surgery, Mount Zion Medical Center of UC-San Francisco

The evaluation of a neck mass begins with a thorough history, taken with the differential diagnosis in mind so pertinent questions can be asked. The physical examination should evaluate the cervical lymph nodes, skin, thyroid gland, major salivary glands, oral cavity and oropharynx, larynx and hypopharynx, and nasal cavity and nasopharynx. The findings from the history and physical examination determine the next steps in the workup and management of a neck mass; options include empirical therapy, ultrasonographic scanning, computed tomography (CT), fine-needle aspiration (FNA), and observation alone. Because most neck masses in adults are abnormal and are often manifestations of serious underlying conditions, further diagnostic evaluation should be pursued. Biopsy, including FNA, and imaging studies are discussed. The management of inflammatory and infectious disorders, congenital cystic lesions, benign neoplasms, primary malignant neoplasms, and metastatic neoplasms is discussed. This chapter contains several references and recommended reading resources.

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