Evaluation of a neck mass
- 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 physicians. 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.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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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