Finding a lump on the neck, no matter what it is or what area it’s found, presents a challenge. If it’s big, there’s a feeling that people are staring. If it hurts, then it’s uncomfortable.
If we don’t know what it is, then it’s worrisome. Here, we talk about what the possible causes of neck lumps are and how to get rid of them.
The neck contains a lot of structures ranging from blood vessels to muscles, nerves and even organs. These are located in different parts of the neck, often separated by muscle sheaths and are sometimes in close contact.
Neck swellings or lumps are very common and are of varying sizes. When there is a swelling or lump on the neck, the specific location is a key detail as it may explain the organ or structure involved.
What Are Neck Lumps?
These are swellings on the neck. They are usually a result of disease to the skin on the neck area or underlying organs. Some of the structures that may be affected include muscles, nerve tissue and their coverings, blood vessels, and organs like the thyroid and the parathyroid glands.
What Could Form A Lump In The Neck?
Neck lumps vary in type and size, based on the particular cause of the swelling. They are of different causes based on the tissues affected. Thus, there are quite a number of different sources of neck lumps. Neck lumps are often grouped by location. The following are some causes of neck lumps:
- Lymph nodes: The most common neck lumps are swollen lymph nodes in the neck. Lymph nodes are small organs throughout the body that help protect the body from diseases. There are more than a hundred lymph nodes in the neck alone and there may be a nodal swelling mostly due to an infection or less commonly, a malignancy. Lymph node neck swellings are found mostly on either side of the neck as round, small but firm lumps.
- Salivary glands: Salivary glands under the jaw may also get swollen as a result of infection, the presence of a stone or tumors.
- Muscles: The muscles in the neck may become swollen or enlarged due to injury and is commonly found in front of the neck. Torticollis, which is also called ‘wry neck’, is a condition where the neck muscles cause the head to twist leading to bulging neck muscles.
- The thyroid gland: Responsible for producing thyroid hormones which regulate body metabolism, heart rate, and temperature. The thyroid gland may become swollen (forming a Goitre) or contain one or more lumps, due to disease or malignancy. This is commonest in women and adults with the reason for thyroid enlargement often unknown in a number of cases.
- The parotid gland: The parotid glands at the jaw area may also have swellings in disease states.
- Lipomas: These are benign collections of fat cells that can occur in any part of the body, including the neck.
- Cysts in the skin, as well as rare tumors of blood vessels, may also be found in the neck area.
- The Human Papilloma Virus (HPV) also increases the possibility of cancer, particularly in the tonsils and the back of the tongue’ which may lead to a neck swelling. Exposure to the virus is often years prior to the occurrence of the neck swelling and is commonly through sexual transmission.
What Other Symptoms Should You Watch Out For?
Most lumps in children are due to an infection, or inborn causes (congenital origin). In adults, most neck lumps are (fortunately) not cancerous and can be promptly treated.
All neck lumps have to be checked out right away by a medical professional, whether they are in adults or in children. Resolution of the lump is paramount because no healthy human should have a neck swelling.
If you have a neck lump and any of the following symptoms, you should see your doctor as soon as possible:
- Unplanned weight loss
- Hoarseness or change in voice lasting for longer than three weeks
- Night Sweats
- Persistent irritating cough or coughing out bloody sputum
- Difficulties with swallowing
- Difficulty in breathing
- Recurrent fatigue
- Oral sores
- Have a firm, painless swelling
How Are Neck Lumps Differentiated and Diagnosed?
Your doctor will ask you a few questions about the neck lump such as
- your age
- changes in size or location
- the presence of lumps on other body parts
- prior lumps in the neck
- changes in its feel and color
Subsequently, your doctor will perform a physical examination with a more specific examination of your neck which may require the use of special instruments.
After the examination, a large chunk of lumps can be diagnosed at this stage with only a few questions left unanswered. Your doctor may also order blood tests, a biopsy (a piece of the swelling is taken and studied under a microscope) and imaging tests which may include an ultrasound or other ‘high-tech’ scans of the neck area such as an MRI or CT scan.
Thereafter, a diagnosis is made and subsequently, a treatment plan is proposed, often handled by a team of ear, nose and throat specialists, oral and maxillofacial surgeons, anesthetists and physicians.
The path to treatment is totally dependent on what could be causing the neck lump. the treatment could be as simple as reassurance to as complicated as surgery or even chemotherapy or radiotherapy.
How Are Neck Lumps Treated?
Treatment is possible for many neck lumps but often specifically tailored, based on the specific cause of the neck lump and the stage. Considering how varied this is, treatment may take many different forms. However, here are the different modalities used in treating neck lumps:
- Medications: This is especially useful for neck lumps of a thyroid origin. These hormone-containing drugs may be used to treat the neck lump by suppressing or increasing thyroid activity. For infections that can lead to swollen lymph nodes, antibiotics may be prescribed.
- Surgery: In cases where the neck lump cannot be treated using medications, is in the early stages and is surgically treated, surgery is offered. This may mean the partial or total removal of the source of the lump and is especially useful for tumors originating from essential neck structures, like the thyroid. Depending on the particular surgery to be done, it may be as short as 30 minutes or as long as several hours. General anesthesia is often the preferred option when anesthesia is employed.
- Chemotherapy: This refers to the use of medications (anti-cancer drugs) to combat diseases, which in this case is cancer. It is given intravenously and divided into courses, with about a three-week interval between courses. It may be given before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy). Your doctor will explain the procedure, side effects and may prescribe medications to alleviate these side effects.
- Radiotherapy: This is the use of high energy radiation to kill the cancer cells. In cases of neck lumps with a cancerous origin, radiotherapy may be required. It may be given in combination with chemotherapy as chemoradiation.