I have a neck lump, what should I do?

Some lumps in the neck resolve on their own, but if you have a lump that has not settled after two weeks, you should see a specialist for assessment. Mr Jonathan Bernstein, a consultant ENT surgeon based in London, has particular experience in this area, and in this article, explains what you should do if you notice the presence of a neck lump.

What should I do if I notice a lump in my neck?

If you have noticed a neck lump, you should first consider the following questions:

• Is it soft to touch?
• Does it come and go?
• Is it getting smaller in size?

If you can answer ‘yes’ to these questions, then your neck lump is unlikely to be serious, but it may still need to be checked out.

Many lumps in the neck do not need surgery, but if surgery is needed you need to be seen by a head and neck surgeon with specialist expertise who carries out a lot of open tumour neck surgery in the NHS.

What could a lump in my neck be?

Many conditions can cause a neck lump, which is sometimes also referred to as a neck mass. They can be large and visible or very small. Most are harmless, but sometimes they can be a sign of something more serious. So, let's take a look at the most likely causes.

• Swollen lymph node

A swollen lymph node is the most common type of neck lump. Lymph nodes are naturally present in the neck but most of the time you can’t feel them. They can enlarge with an infection such as a sore throat, a cold, tonsillitis or glandular fever. The enlarged lymph nodes usually reduce in size after the infection improves.
 

Malignant causes of lymph node enlargement include lymphoma (a malignancy of the lymphatic system) and cancerous cells which have spread from the upper aerodigestive tract (including the mouth and tongue, throat, voice box and nose).

The assessment of swollen glands in the neck should therefore include a clinical examination of these areas. The possibility of some forms of throat cancer increases with smoking, alcohol consumption and age, but some forms of throat cancer can occur without a history of smoking or drinking.
 

• Salivary gland swelling

A salivary gland swelling may be an infection, a blockage by a stone, or a benign or malignant tumour. The major salivary glands are the parotid gland (in front and below the ear), the submandibular gland (under the jaw bone), and the sublingual gland (under the tongue). There are also minor salivary glands throughout the mouth. Swellings in any of these areas should be assessed by a head and neck specialist.

• Thyroid lump

A thyroid lump or swelling could be caused by a goitre, one or more thyroid nodules, thyroid cancer or lymphoma. You can find Mr Bernstein’s article on thyroid cancer here. A thyroglossal duct cyst can cause swelling in the neck just above the middle part of the thyroid gland.

• Skin lesion

A skin lesion may be a skin tag, acne with boils, an abscess, a cyst, or skin cancer. Mr Bernstein has expertise with various skin cancers of the face and neck.

If you have developed a neck lump you should seek professional medical advice from your GP or a head and neck consultant surgeon/ENT specialist. Mr Bernstein has a high-volume experience and practice in this area and would be glad to help you.