Any lump or swelling on the neck is considered a neck mass. Neck masses are relatively common, both in childhood and adulthood, and may be the result of swollen lymph nodes or swelling of the muscles of the neck, known as torticollis, which usually appear on the front of the neck.
Some lumps on the neck may produce no symptoms and may disappear within a few days. Nonetheless, some neck masses may be serious or even life-threatening. Any swelling on the neck that remains for a week or more should be evaluated by a physician.
Causes of Neck Masses
The most common cause of neck masses is enlarged lymph nodes. Other causes may include thyroid disorders, swelling of salivary glands and malignant tumors.
Enlarged Lymph Nodes
Lymph nodes in the neck may enlarge for several reasons, including bacterial or viral infection or a local or systemic cancer.
A common cause of swollen lymph nodes in the neck is a localized bacterial infection. Such an infection may be an infected cyst, or may be the result of a dental abscess, a traumatic injury, an inflammation of the salivary glands, tonsillitis or a strep throat. Systemic bacterial infections may also be responsible for swollen lymph nodes in the neck. Such infections include cat scratch disease and tuberculosis.
Viral disease may be the underlying cause of enlarged lymph nodes. Such viral diseases include: German measles, viral sore throats, herpes infections, mononucleosis and some sexually transmitted diseases, such as AIDS and HIV.
Certain cancers may also cause swollen lymph nodes in the neck. These include cancers of the mouth, leukemia, Hodgkin's disease, non-Hodgkin's lymphoma and melanoma.
Another reason for neck masses may be a disorder of the thyroid gland, resulting in an enlargement of the gland itself or the development of nodules in the region. These masses may result from goiter, thyroid cancer, or Graves disease.
Salivary Gland Enlargement
The salivary glands may enlarge, causing a lump in the neck, for a variety of reasons. A salivary gland itself may be infected or cancerous, or a salivary duct may be blocked by a stone. The salivary glands also enlarge significantly when a patient has mumps.
Allergic reactions as a response to medications, particular foods or other substances may cause swelling in the neck. If such an allergic response occurs suddenly or is accompanied by wheezing or breathing difficulties, it is a medical emergency.
Diagnosis of Neck Masses
Since there are such diverse causes for neck masses, with such wide-ranging degrees of severity, proper diagnosis is essential. In addition to performing a complete physical examination and taking a patient history, the physician may administer diagnostic tests to rule out or pinpoint certain disorders. Diagnostic tests for neck masses may include:
- Blood Tests
- Biopsy of tissue
- CT scan
- MRI scan
- Radioactive thyroid scan
- Bone marrow biopsy
Treatment for Neck Masses
When neck masses are caused by allergies, treatment may include administration of antihistamines, corticosteroids or, in severe cases, epinephrine to prevent or treat anaphylaxis. When neck masses are caused by bacterial infections, they are treated with antibiotics. When neck masses are the result of disease processes, the underlying causes must be treated. If tumors are present, surgery may be necessary.