Neck lumps: When to worry and when to see an ENT specialist

A lump in the neck can be concerning, but in many cases, it is harmless and temporary. However, some neck lumps may indicate an underlying medical condition that requires attention. Understanding the possible causes and warning signs can help determine when to seek advice from an ear, nose, and throat (ENT) specialist.

What are the common causes of neck lumps?

Neck lumps can develop due to various reasons, including:

• Swollen lymph nodes – Often caused by infections such as colds, flu, or throat infections.
• Cysts – Fluid-filled sacs that can form due to congenital conditions or blockages.
• Thyroid nodules – Growths in the thyroid gland, which may be benign or, rarely, cancerous.
• Salivary gland swelling – Can result from infections, stones, or tumours in the salivary glands.
• Lipomas – Non-cancerous fatty lumps under the skin.
• Infections or abscesses – Can cause painful swelling and may require treatment.
• Tumours – Benign or malignant growths in the throat, thyroid, or other structures.

When should you worry about a neck lump?

While many neck lumps are harmless and resolve on their own, certain signs may indicate a more serious condition. Seek medical advice if the lump:

• Persists for more than two weeks without signs of improvement.
• Feels hard or fixed rather than soft and movable.
• Grows rapidly or continues to increase in size.
• Is painless, as some concerning lumps do not cause discomfort.
• Is accompanied by other symptoms, such as:
  • Unexplained weight loss
  • Difficulty swallowing or breathing
  • Hoarseness lasting more than a few weeks
  • Night sweats or persistent fever

When should you see an ENT specialist?

An ENT specialist should evaluate a neck lump if:

• It does not go away after a couple of weeks.
• It keeps getting larger or changes in shape.
• There are associated symptoms, such as persistent throat pain, swallowing issues or voice changes.
• You have risk factors, such as a history of smoking, alcohol consumption, or previous cancers.

How are neck lumps diagnosed?

An ENT specialist may perform:

• Clinical examination – Feeling the lump and checking for related symptoms.
• Ultrasound scan – To assess the lump’s size, shape and structure.
• Blood tests – To check for infections or thyroid-related issues.
• Fine needle aspiration (FNA) biopsy – To collect and examine cells from the lump.
• CT or MRI scans – For a detailed view of deeper structures.

What are the treatment options?

Treatment depends on the underlying cause of the lump:

• Infections – Antibiotics or antiviral medication if caused by bacteria or viruses.
• Cysts and benign lumps – May require drainage or surgical removal if problematic.
• Thyroid or salivary gland issues – Treatment may include medication, monitoring, or surgery.
• Cancerous lumps – Require a combination of surgery, radiotherapy, or chemotherapy, depending on the type and stage.

Most neck lumps are benign and temporary, but persistent or unusual lumps should not be ignored. If a lump lasts more than two weeks, grows, or is associated with other symptoms, an ENT specialist evaluation is recommended to rule out serious conditions and ensure appropriate treatment.