A neck lump is any lump, bump, swelling or mass in the neck. The majority of neck lumps are non-cancerous enlarged lymph nodes or thyroid nodules. However, these non-cancerous neck lumps are often difficult to differentiate from cancerous neck lumps without specialist assessment and investigations. 15% of patients attending our neck lump clinic have a cancerous neck lump.
Neck lumps persisting beyond 3 weeks are concerning for cancer – either a primary cancer in a lymph node (lymphoma) or a secondary cancer in a lymph node that has spread from a primary cancer somewhere in the head and neck, or rarely from somewhere distant from the head and neck.
Specialist evaluation to assess and diagnose your neck lump with minimal delay is necessary when the lump:
- is enlarging, or
- is greater than 2cm, or
- persists beyond 3 weeks and is changing, or
- persists beyond 6 weeks, or
- is associated with a skin ulcer in the head and neck, or
- is associated with an ulcer, lump or bleeding in the mouth / tongue / throat, or
- is associated with pain in the mouth / tongue / throat / ear, or
- is associated with a change in swallow or voice, or
- is associated with malaise, fever, night sweats, weight loss, or
- is associated with lumps in other body regions
We offer the only ‘one-stop’ diagnostic neck lump clinic where you will have access to a surgeon, radiologist and pathologist at a single appointment with the objective of offering a complete neck lump assessment concluding with a diagnosis and treatment plan. The assessment includes:
- Medical history
- Examination including inspection of the oral and nasal cavities, throat, voice box, and neck, using a small mirror and/or lights. Your surgeon may also feel for lumps in the mouth, lips, neck, and face.
- Endoscopy of the nasal cavity, throat (pharynx), and voice box (larynx). Endoscopy involves assessment of the inside surfaces of the body using a very thin, lighted tube called an endoscope.
- Ultrasound scan of the neck performed by a specialist radiologist. This scan uses high-frequency sound waves to obtain a picture of structures in the neck and to assess the size and nature of the nodule(s). Some ultrasound findings of are highly suggestive of non-cancerous lumps. However, ultrasound alone may not be able to distinguish between non-cancerous and cancerous neck lumps.
- Fine needle aspirate biopsy (FNA) of the neck lump. This procedure is a routine test and can be very useful for diagnosis. A small needle passed into the neck lump through the overlying skin sucks a small amount of cells out of the lump.You can go straight back to work after the test.
- Immediate FNA biopsy cytology assessment by a pathologist, who is present in the clinic and studies the tissue biopsy under a microscope to make a diagnosis. A biopsy is the only sure way to tell whether a person has cancer.
- Additional biopsies of the neck lump or any other abnormality found during the examination may be taken following administration of local anaesthesia.
- The complete assessment and consultation with provision of results is completed in approximately 45 minutes.
- Also refer to Head and Neck Cancer.
All the procedures necessary to establish the diagnosis of your neck lump can usually be performed at your first neck lump clinic visit. Your surgeon will explain the results of the tests, including the FNA biopsy, and recommend a treatment plan during the same appointment. Occasionally, the FNA biopsy does not provide the diagnosis and an open biopsy or other investigation (e.g. CT scan) may be recommended. An open biopsy entails a taking a larger piece or all of the neck lump. This is a minor operation which is often performed under local anaesthesia.