Common causes
The neck contains many lymph nodes, which swell when they fight infection, for example after a sore throat, a cold or a dental infection. These lumps are often tender and shrink over two to three weeks.
Other causes include cysts present from birth, swellings of the thyroid or salivary glands, and lumps in the skin. Less often a lump is a cancer, either starting in the lymph nodes (lymphoma) or spreading from a cancer of the mouth, throat, voice box, thyroid or skin.
Warning signs
A lump that has lasted more than three weeks, is growing, or feels hard and fixed. Hoarseness for more than three weeks, difficulty or pain on swallowing, pain in one ear, a sore in the mouth that does not heal, or coughing up blood. Unexplained weight loss, fevers or drenching night sweats.
Smoking and drinking alcohol increase the risk of head and neck cancer, so these signs matter even more in smokers and drinkers, but they should be checked in anyone.
How it is investigated
Dr Kana asks about the lump and your health, examines the neck, mouth and throat, and looks at the back of the nose, the throat and the voice box with a thin endoscope in the rooms. This takes a few minutes, with a local anaesthetic spray.
An ultrasound scan with a fine needle sample is usually the next step, and a CT or MRI scan may be arranged. A lump should not be cut out before this assessment is complete, because the way it is removed can affect later treatment.
Treatment
Treatment depends on the cause. Lumps from infection usually settle with time or antibiotics. Cysts and other benign lumps can be removed if they cause trouble. If the lump is a cancer, the plan is agreed with oncologists and other specialists, so that you hear one recommendation.
Common questions
My child has lumps in the neck. Should I worry?
Small, soft glands that move under the fingers are very common in children and usually reflect frequent colds. See a doctor if a lump is larger than about two centimetres, keeps growing, or comes with fever, weight loss or night sweats.
Should I try antibiotics first?
If there is a clear infection, a doctor may prescribe them. But a lump that is still there three weeks later should be examined, even if it has shrunk a little.
Can I send my scans before I travel?
Yes. Ultrasound, CT or biopsy reports from home help Dr Kana advise on the next step, and may shorten your stay.
This page is general information, not medical advice for your situation.
