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Head and Neck Cancer

Throat ExamLumps, growths, and tumors are fairly common in the neck. While each of these can be considered a mass, such findings can be organized into those which are benign, and those which are cancerous. If you find a lump in your neck that persist for 2 weeks or longer, it is important to have it checked. Whether benign or cancerous, early diagnosis and treatment is associated with better outcomes.

Types of Head and Neck Masses

There are many types of head and neck masses:

Enlargement of lymph nodes – this is the most common cause of a neck mass. Lymph nodes are part of your immune system and often become enlarged if you are fighting an infection. Their size should shrink once the infection clears. If a lymph node stays enlarged, it should be checked.

Benign lesions – Benign masses may grow, but do not spread to other parts of the body. There are many such benign masses which can be found in the neck and include cysts, thyroid masses, vascular masses, and salivary gland masses.

Cancerous lesions – If a cancerous mass is found in the neck, it may represent a primary tumor which started within the neck, or may represent a metastatic lesion which has spread from somewhere else in the region.

Primary tumors which originate in the neck include the thyroid, throat, larynx, and salivary gland. These cancers may also spread to lymph nodes within the neck. Tobacco and alcohol cause the vast majority of such cancers. Oral cancers can also be caused by a virus called HPV. Oral cancers in younger adults are typically associated with HPV, whereas cancers in older adults are most often caused by tobacco and alcohol.

Secondary cancers are tumors that have spread tolymph nodes or soft tissue from somewhere else in the body. It is critical to find out both where the original cancer started as well as to discover the extent of its spread.

Symptoms to watch for

You should see your physician if you experience any of the following symptoms:

  • Lump in the neck persisting for more than two weeks, especially if it is not associated with a recent infection.
  • Voice changes or hoarseness that persists more than two weeks
  • Growth in the mouth
  • Blood in the saliva or mucus
  • Swallowing problems
  • Skin changes: these can include ulcerations, recurring sores, pigment changes, or growing lesions. Basal cell carcinoma, squamous cell carcinoma and melanomas can all appear within the head & neck.
  • Ear Pain — may be seen with certain infections or be caused by a growth in the throat

Diagnosing Head and Neck Masses

A thorough head and neck physical exam is the starting point in the evaluation of any head & neck mass. Based on those findings additional tests may be required and can include:

  • Fiberoptic exam: This is a relatively simple in-office procedure which allows your physician to examine areas such as the nasal cavity, nasopharynx, pharynx, and larynx.
  • Ultrasound: sound waves are used to create images of soft tissue structures. No radiation is utilized. Ultrasound is most often used to image the thyroid and can be used in children to evaluate cysts, lymph nodes and other soft structures.
  • CT scan: CT scans are the most common type of imaging done for neck masses. CT scans provide a 3-dimensional picture of the body and are used to determine the origin, size, and spread of tumors.
  • MRI – Magnetic Resonance Imaging also provide 3 dimensional images, but use a magnetic field rather than x-rays to create their pictures.
  • PET (Positron Emission Tomography) scans: These scans are used after a diagnosis of cancer has be made. PET scans can show where cancers originate and where they have spread
  • Biopsy – Biopsies can be done both using a fine needle technique as well as surgically. Tissue is sent to a pathologist to determine its tissue type as well as whether it is benign or malignant.

Treating Head and Neck Masses

Treatments are determined by the cause of the mass. Benign neck cysts and masses are usually removed by surgical excision. Head and neck cancers are most often treated by some combination of radiation therapy, chemotherapy, and surgery.