As a topic of discussion, the “neck mass” category is extremely broad.  Many of the diseases discussed in other sections of this site can present with, or eventually lead to, the development of a neck mass.  Therefore, this page will focus on some general concepts to consider when dealing with a new neck mass and also provide more specific information on diseases not covered elsewhere in his site.  We will begin with a general recommendation that will be reinforced throughout this segment:  Any new neck mass should be immediately reported to your doctor, and if the mass lasts longer than a few weeks or grows or fails to improve with medical management, it should be evaluated by a head and neck surgeon.

Lymph Nodes

Commonly, when a new neck mass is identified, it is one of the hundreds of lymph nodes that are present in the head and neck.  Since the function of the lymph system and lymph nodes is to drain body fluids and sample for infections, lymph nodes usually get larger during an acute infection.

The illustration above demonstrates the extensive network of lymph channels and lymph nodes in the head and neck region.  Again, when one of these enlarges, infection is though of first and antibiotics are usually recommended.  However, more dangerous diagnoses such as metastatic cancer and lymphoma may need to be ruled out.  Any neck mass lasting longer than a few weeks, or which grows or fails to improve with medical management, should be evaluated by a head and neck surgeon.  Workup may include needle biopsy, imaging with CT or MRI, and endoscopy to make sure there are no suspicious lesions or tumors in the lower throat and larynx.  In some cases, workup may lead to the recommendation of more aggressive surgery.

Cysts

Cysts that develop in the head and neck region may be small extensions of the overlying skin (such as sebaceous cysts) or larger, deeper cysts that have been present since birth.  The most common of these include branchial cleft cysts and thyroglossal duct cysts. They can occur in many different sites of the neck and usually present once infection causes swelling or the cyst to fill with fluid.  Once present, removal is generally recommended.  Depending on the location, cyst removal can be either simple or complex.  The head and neck region houses many important arteries, veins, and nerves that must be preserved when removing benign masses such as cysts.  Such cases are best performed by an experienced head and neck surgeon.

Neoplasm 

A tumor is any mass that is present where it doesn't belong.  It can be caused by many different processes and is not an automatic diagnosis of cancer.  A neoplasm is a tumor that is caused by an abnormal rapid proliferation of cells.  Usually, this is from a single abnormal cell that divides and grows in an abnormal accelerated fashion.  Cancer is a term that describes malignanant neoplasms.  That is, the cells that grow and divide uncontrollably can invade local tissues and spread to distant sites.   In the head and neck, there are many types of tissues that can lead to the development of a neoplasm.  Nerves, muscles, saliva glands, skin are all candidates.  Again, any mass that is present for more than a few weeks needs to be evaluated as soon as possible to rule out a neoplasm and potential cancer.