Mass or swelling in the neck - Causes and Symptoms

Definition

The presence of a mass or swelling in the neck recognizes many causes, including infections, congenital pathologies and tumors that originate in one of the local anatomical structures. In the oropharynx, for example, swelling may occur in response to a bacterial or viral infection (most commonly pharyngitis or upper respiratory tract infections; sometimes, a dental infection). Some systemic infections (eg, mononucleosis, HIV and tuberculosis) cause enlargement of the cervical lymph nodes, usually generalized. Congenital pathologies can cause a typically chronic swelling of the neck, that is, of long duration (eg cysts of the thyroglossal duct, dermoid or sebaceous cysts). Tumor masses are more widespread among elderly patients, but may also appear in younger people. The presence of a mass in the neck can represent a primitive tumor localization or a nodal involvement secondary to a local primitive neoplasm or to regional or distant metastases (for example, with origin in the upper respiratory or digestive tract). The thyroid can swell in various diseases, including goiter, thyroiditis and tumors, causing a more or less visible and uniform neck swelling.

Important differential diagnostic factors for a swelling of the neck include acute or chronic onset, pain, consistency, mobility and the presence of any associated symptoms. A swelling that begins in a few days indicates the probable presence of an upper respiratory tract infection or pharyngitis. A chronic mass, on the other hand, suggests the presence of a cyst; however, a tumor or thyroid origin (benign or malignant) must be excluded. Pain or tenderness at palpation of the neck suggests an inflammatory cause (in particular an infection). Instead, a solid and fixed mass to the underlying tissues is more likely to be cancerous. In any case, a thorough oropharyngeal examination by the doctor is important.