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Continue to Head & Neck Lumps & Bumps Part 2 -Diagnosis & Treatment
Cervical lymphadenitis(inflammation of the lymph nodes in the neck) is very likely the most common cause of an inflammatory mass in the neck. This condition is characterized by painful enlargement of normal lymph nodes in response to infection or inflammation, commonly due to upper respiratory infection such as a cold or sinus infectionOn the other hand, tumours (known as 'neoplasm' from a medical perspective) can be benign i.e non-cancerous or malignant i.e cancerous. Some of these benign/non-cancerous tumours can arise spontaneously without any particular triggering factor. On the other hand, malignant tumours are what is commonly known as CANCERS. Cancers are commoner in adult (still possible in younger age group but less likely). Benign tumours are more commonly slow-growing while cancerous tumours generally grow much faster and may even invade the skin. The likelihood of the lump being a cancer increases as adults age, particularly for people who smoke or drink significant amounts of alcohol. However, most lumps in adults are not cancers (fortunately)Common risk factor for cancer include:•chronic smoking, betel nut chewing, tobacco chewing,•chronic alcohol consumption •immunodeficiency •Human papilloma virus (HPV) viral infection•poor dentition•industrial or environmental exposures•positive family history -first degree relatives with cancer.
Benign blood vessel tumour from the nose
Neck lymph node enlargement due to nasopharyngeal cancer
Benign tumour of fat cell origin next to the parotid gland
Benign tumour arising in the parotid gland
Benign tumour of nerve origin arising just next to the carotid artery
Benign growth of the thyroid gland - goitre.
Benign cyst of development origin in the upper neck.
Benign cyst arising from the skin layer in the face
Benign cyst arising from the skin layer in the upper neck
Cancerous growth in the voice box of a chronic smoker.
A neck lump is any lump, bump, mass or swelling in the neck. It is something that commonly brings a patient to his doctor. One of the major concerns is : "DOCTOR, IS THIS A CANCER?" As such, all neck lumps in children and adults should be checked without undue delay.
Head and neck masses are malignant, or cancerous, if they spread to surrounding tissue. In the head and neck, cancers may be either primary or secondary. Primary cancers originate in the head or neck itself, including the thyroid, throat, larynx, salivary gland, brain, or other locations. Primary cancers of the head and neck typically spread to the lymph nodes in the neck, presenting as neck swellings. (to complicate matters, these swellings as look and feel just like a node swelling due to an infection of the neck !). Your doctor may call these neck nodes as "metastatic" or "secondary" neck nodes.Secondary neck nodescan also less commonly have spread from primary cancers in other parts of the body outside the head or neck region eg lung, breast, kidney, or from the skin.
Congenital head and neck lumps or masses can arise during early years or may present later in life. These include embryological remnants since 'in utero' (while you are still in your mother's womb) eg. thyroglossal duct cyst, dermoid cyst or branchial anomalies among others.As illustrated in the picture above, the head and neck region is made up of many different structures and many of these structures can either get infected giving rise to a lump or grow into a tumour over time, whether cancerous or otherwise. Examples of these structures include:•Skin•Subcutaneous tissue under the skin•Lymph nodes or lymphatic tissue•Nerves•Vessels (veins or artery)•Salivary glands (eg. parotid, submandibular gland)•Thyroid gland•Bones (eg jaw bone)Infection can arise as a result of infection by viruses, bacteria or fungus. Occasionally, the lymph node becomes necrotic, and an abscess forms. In our region, tuberculosis (TB), due to infection from a special type of bacteria known as mycobacterium, is also quite common and becoming increasingly more prevalent. Besides being notoriously difficult to detect, it can masquerade as infection in any parts of the body, commonly in the lungs and the neck lymph nodes.
(Please click on picture for larger view)
Secondary cancer spread to the lungs (red arrows) as seen on the chest X-ray
DR. VINCENT TANConsultant Ear, Nose and Throat, Head and Neck Surgeon,MD (UKM), MS ORL-HNS (UKM), DOHNS RCS Edinburgh (UK), MRCS Edinburgh (UK), Postgrad. Cert.in Allergy (UK), A.M. (Mal), Fellowship in Rhinology (Singapore)Fellowship in Head and Neck Oncology & Surgery (Amsterdam)