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Neck lump - Management
How should I make a diagnosis?
- Use the findings from the history and examination to guide diagnosis. The position of the lump should help narrow down the list of likely causes.
- Midline — thyroid swellings (isthmus), thyroglossal cyst, laryngeal swellings, submental lymph nodes, dermoid cysts.
- Lateral (anterior triangle) — thyroid swellings (lobe), pharyngeal pouch, submandibular gland swelling, branchial cyst, lymph nodes, parotid swelling.
- Lateral (posterior triangle) — lymph nodes, carotid artery aneurysm, carotid body tumour, cervical rib.
- Age can also help to determine the likely cause of a neck lump.
- Children are most likely to have reactive lymphadenopathy of cervical nodes. Single masses are often due to a congenital cause or to inflammation. Malignancy is rare, with lymphomas, thyroid cancer, and soft tissue sarcomas being most likely.
- Adults — young adults will usually have an inflammatory, developmental, or congenital cause; malignancy is less common. The likelihood of malignancy increases with age, particularly in people 40 years of age or older.
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