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Neck lump - Management
What should I ask about?

  • Ask about the site of the lump, including its onset, growth, and changes (and the timescale of these), and any pain.
  • Check for red flag symptoms that are suggestive of:
    • Local malignancy (for example weight loss, difficulty swallowing or painful swallowing, persistent hoarseness, earache, or sore throat — particularly when unilateral).
    • Haematological malignancy:
      • Fatigue.
      • Drenching night sweats.
      • Fever.
      • Weight loss.
      • Generalized itching.
      • Breathlessness.
      • Bruising or bleeding.
      • Recurrent infections.
      • Bone pain, alcohol-induced pain, or abdominal pain.
      • Lumps (lymphadenopathy) at sites other than the neck (for example the axillae).
  • Consider other features in the history suggesting a cause:
    • Combination of symptoms indicative of an upper respiratory tract infection causing lymphadenopathy — fever, cough, and sore throat.
    • Recent travel, insect bites, or exposure to pets or other animals — suggestive of an inflammatory or infectious cause of neck mass.
    • Smoking, heavy alcohol use, or previous radiation to the neck — increase the risk of malignancy.
    • Trauma — may indicate haematoma, or if time has elapsed since the traumatic incident, fibrosis.
    • Family history of an endocrine tumour — may be suggestive of multiple endocrine neoplasia (MEN) type 2 (thyroid, adrenal, and parathyroid disease).

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