Benign and Malignant Neck Masses

Neck masses can be common in adults. In adults over the age of 40, a neck mass that has persisted for more than two to three weeks should be evaluated by your physician to determine an underlying cause.

In most cases, malignant (cancerous) neck masses spread from a primary cancer – typically of the upper digestive tract or face and scalp skin. This is called metastasizing. Additional causes of malignant neck masses come from primary cancers of the neck, such as thyroid gland cancer; systemic malignancies (those that affect other parts of or the entire body), like lymphoma or leukemia; or cancers that spread from other distant parts of the body.

Symptoms, Diagnosis and Outlook

If you have a neck mass that does not go away within two to three weeks, make an appointment with your physician to have it checked. The most common symptoms of a neck mass include:

  • A mass that increases in size
  • A mass that decreases in size, but does not go away
  • Difficulty swallowing
  • Ear pain
  • Fever
  • Throat or neck pain
  • Voice changes

To diagnose a neck mass, a Penn State Health head and neck specialist, called an otolaryngologist, will perform a physical examination that usually includes a flexible upper airway endoscopy in the office. Additional diagnostic testing can include:

  • Contrast-enhanced computed tomography (CT) scan – typically used for initial neck mass diagnosis
  • Fluid cultures or gram stains – to determine if an infection is present
  • Positron emission tomography (PET) – can identify the primary malignant lesion that metastasized to the neck
  • Ultrasound-guided fine-needle aspiration (FNA) biopsy of neck mass – provides information about malignancy and the source of the mass

Our team may recommend an upper aerodigestive tract biopsy for patients with a malignant metastatic neck mass with no obvious source, like primary cancer. The biopsy is performed under anesthesia.

Our Penn State Health otolaryngology team is experienced, skilled and committed to your health, safety and well-being. We will work closely with you to determine the best treatment plan and provide support services before, during and after treatment for your neck mass.

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Why Choose Penn State Health for Care

Multidisciplinary Neck Mass Expertise

The Penn State Health otolaryngology team of experienced surgeons, physicians and support staff are here to assess your neck mass quickly. Our goal is to diagnose the neck mass and create a treatment plan specifically designed for your health needs.

For our pediatric patients, we have a comprehensive, dedicated pediatric otolaryngology team at Penn State Children’s Hospital. Our team will perform a thorough evaluation and create a treatment plan that can include medical management, surgery or careful observation. Many neck masses in children are benign, but require regular monitoring by a specialist.

Leading-Edge Neck Mass Treatment Options

Treatment for adult neck masses can vary greatly. Our team will provide you with information on all treatment options based on the nature of your mass and diagnostic testing results. Patients with infected lesions can be treated with antibiotics, while benign (noncancerous) lesions, like cysts, can be monitored and surgically removed.

Most malignant neck masses will be surgically removed in combination with chemotherapy and radiation therapy. If you are diagnosed with a malignant neck mass, the Penn State Health otolaryngology team will work closely with your medical oncologist to create a comprehensive, multidisciplinary treatment plan.

Commitment to Clinical Trials

The otolaryngology team at Penn State Health Milton S. Hershey Medical Center is committed to furthering neck mass research. We are actively involved in clinical trials to research safe and effective treatment options that also preserve function and quality of life. To learn more about clinical trials available at Penn State Health, visit our StudyFinder.

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