Evaluation of a neck mass
- Derrick Lin, MD
Derrick Lin, MD
- Associate Professor
- Harvard Medical School
- Daniel G Deschler, MD, FACS
Daniel G Deschler, MD, FACS
- Section Editor — Otorhinolaryngology
- Professor of Otology and Laryngology
- Harvard Medical School
A new neck mass is a relatively common head and neck problem in patients presenting to the primary care clinician. There often are no associated symptoms, other than the recognition of a "new lump" noted incidentally on palpation while grooming, or noticed by another individual.
Evaluation of the neck mass must be approached in a thorough and disciplined manner. The mass may be the only manifestation of a serious and potentially malignant pathology, especially in the adult population.
The differential diagnosis in a patient presenting with a neck mass is often extensive and will vary with the age of the patient at presentation. A thorough history and physical examination are essential steps in the evaluation [1,2]. This will narrow the diagnostic possibilities and help determine the appropriate next diagnostic steps, as outlined in an algorithm (algorithm 1).
The diagnostic approach to evaluation of a neck mass will be reviewed here. The differential diagnosis is discussed separately. (See "Differential diagnosis of a neck mass".)
A thorough patient history will often narrow the differential diagnosis of a neck mass.
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- PATIENT HISTORY
- Mass growth pattern
- Other history
- PHYSICAL EXAMINATION
- Anatomy of the neck
- Mass localization
- Characteristics of the mass
- Components of the general examination
- LABORATORY STUDIES
- IMAGING STUDIES
- DIAGNOSTIC STUDIES
- Fine needle aspiration
- Core biopsy
- Excisional or incisional biopsy
- SUMMARY AND RECOMMENDATIONS