Neck lumps

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Luke manages all types of neck lumps to provide a rapid diagnosis and management service.

Neck lumps come in a variety of shapes and sizes and may be painless or painful. They can be on the side of the neck, under the jawline, at the back of the neck or at the front in the throat area. Most neck lumps are not serious – the neck is full of glands called lymph nodes that swell up in response to any infection. Sometimes they take a while to subside and become more noticeable.

Common causes of neck lumps

  • Swollen lymph nodes or tonsils due to infection – neck lumps are typical of several viral infections such as mumps, TB or glandular fever
  • Sebaceous cysts in the skin
  • Lipomas – fatty cysts just under the skin that can occur anywhere
  • Thyroid problems – the typical example is goitre
  • Problems with the parotid gland – one of the salivary glands
  • Cancer – lumps in the neck can also be one of the first signs of head and neck cancer

Remember that most neck lumps are not cancer but if you have a neck lump that is worrying you it is best to get it checked out. By doing so you can either set your mind at rest or you can get prompt treatment.

Your initial consultation

When you come to see Mr Luke Cascarini, he will start by asking you detailed questions about your symptoms and your medical history.

  • When did the neck lump or lumps appear?
  • Have they grown rapidly, slowly or not at all?
  • Are they painful all the time, just when touched, or completely painless?
  • What makes the lump feel worse or better?
  • Have you had an infection or injury recently?
  • Have you any other symptoms other than the neck lump/lumps?
  • Are you having any trouble swallowing or breathing?
  • Have you had any serious illness or other diagnoses in the last few years?
  • How is your general health?

Luke will then examine your neck thoroughly and then make recommendations for further tests.

Diagnostic tests

These will depend on your particular neck lumps and symptoms but commonly include:

  • Blood tests – testing your blood can reveal if your white cell count is normal. If it isn’t, that can mean that you may have an infection or something more serious, such as a blood cancer. Some tests can be done for specific viral infections. Luke may think it’s a good idea to check that your thyroid gland is working correctly.
  • A fine needle aspiration biopsy – a fine needle is used to draw off some of the fluid in the lump, together with the cells inside. These are examined under a microscope by a histologist who provides an expert opinion on what the problem could be.
  • Scans – CT, ultrasound, PET scans and MRI scans are all used to investigate neck lumps. X-rays are not used because the soft tissue of a neck lump will not show up in enough detail.
  • Panendoscopy – specially designed endoscopes can be used to look inside the structures of the throat, such as the pharynx, larynx (voice box) and in the top of the windpipe and oesophagus. This is usually done under general anaesthetic as a day case.

Removing neck lumps

If you see Luke for a diagnosis, it is likely that your neck lump will turn out to be benign – most are. Benign lumps are not cancerous and may not need to be removed at all.

If the lump is large, you might want it removed because it is affecting your appearance and your confidence. It may be in a position where it causes problems – such as on the collar line. Other benign lumps may have the potential into turn into something more serious, so it’s a good idea to have them removed earlier rather than later.

Surgical removal of benign neck lumps

This type of neck lump surgery is usually done as a day case. You will have been through your initial consultation and a range of diagnostic tests and Luke will have discussed your treatment options. If you decide to go ahead and have your neck lump removed, he will arrange for your booking to be made at one of his surgical clinics, where the operation will be scheduled.

You will be given specific instructions from the clinic on how to prepare, whether you can eat or drink and what time to arrive. The surgery is likely to be short and, even if you have had a general anaesthetic, you will normally be able to go home later the same day. An overnight stay may be required if your surgery is planned for the afternoon.

Surgical removal of the parotid gland (one of the salivary glands), which can cause a neck lump if it becomes blocked, usually needs a couple of nights in hospital. The incision tends to be larger and a drain might be required.

Surgery to remove cancerous neck lumps

Luke has significant experience and expertise in removing head and neck cancers, which may be detected because they lead to a neck lump.

Removing the cancer often requires quite extensive surgery and the lymph nodes in the neck may also need to be dissected and removed. This is to prevent the cancer spreading to the rest of the body.

Find out more about the removal of lymph nodes, which is called neck dissection.

Luke summarises his expertise


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