Neck Lump Surgery Specialist in Sydney
What are some of the common causes of neck lumps?
There are many different causes of a neck lump, which include both serious and benign causes. The patient’s age, history and physical examination will usually indicate that the neck lump be allocated to one of three categories: congenital/benign, inflammatory or tumour growths. Tumour growths can be either benign or cancers.
Some causes include:
- congenital or benign – branchial cleft cyst, thyroglossal duct cyst, plunging ranula, lipoma
- inflammatory – infected lymph node, thyroiditis, salivary stones and swelling, autoimmune disorder
- tumours growths
- benign – thyroid nodule, benign salivary tumour, multinodular thyroid goitre
- cancers – thyroid cancer, metastatic head and neck cancer, lymphoma, salivary cancer, sarcoma (rare)
As demonstrated above, the causes of a neck lump are broad and extensive, and a careful history, examination and various investigations are required to make the correct diagnosis.
How are neck lumps investigated?
The first step is a thorough history and examination, and often the diagnosis can become quickly apparent at this stage. Further investigations might include blood tests and imaging studies. These vary depending on the situation, but may include ultrasound, CT, MRI and/or PET. In some patients, a tissue biopsy might be required to help establish the diagnosis.
What will occur during my consultation for a neck lump?
Your consultation will begin with a careful history and physical examination, followed by review of your results including blood tests and scans. A bedside office ultrasound will be conducted to provide real-time diagnostic information. A nasendoscopy (thin fibre-optic camera procedure via the nostril) may be performed under local anaesthesia to examine the back of your throat. Further investigations including additional scans and biopsies may be recommended. Treatment options will then be discussed and you will have the opportunity to ask questions in order to make the best decisions for your care.
What is a thyroglossal duct cyst?
A thyroglossal duct cyst is a fluid filled lump in the front of the neck, usually near the midline, just above the voice box. The cyst forms in tissue that is left over from the embryonic development of the thyroid gland. Usually the diagnosis is straightforward. Occasionally complications can occur from the presence of a thyroglossal duct cyst including infection, and there is an estimated 1% risk of cancer in a thyroglossal duct cyst. For these reasons, excision is usually recommended and a Sistrunk operation is performed. In this procedure, the cyst is removed along with a central portion of the hyoid bone which is important to prevent the cyst from re-occurring.
What is a plunging ranula?
A ranula is a benign fluid-filled lump that occurs in the floor of mouth due to blockage of a sublingual or minor salivary gland. Sometimes that fluid-filled cyst becomes very large and ‘plunges’ into the neck, and the patient notices a neck lump. A plunging ranula can cause discomfort, as well as cosmetic concern, and is usually treated with surgery which can be performed via an incision in the neck (transcervical) or via an incision under the tongue (transoral).
What is a branchial cyst?
A branchial cyst is a fluid-filled lump that occurs most commonly on the side of the neck, underneath and the jaw and in front of the sternocleidomastoid muscle, although the location can be highly variable. A branchial cyst forms because of abnormal embryonic development of head and neck structures, but often only becomes apparent in early adulthood (10-40 years of age). Branchial cysts can cause problems including infection, growth and discomfort, and usually surgical excision is recommended for these reasons, and also to rule out more serious problems.
What is the usual treatment for a neck lump?
Obviously the treatment of a neck lump varies considerably based on the diagnosis. We carefully and individually assess each patient and make appropriate recommendations for treatment. You will have as much time as needed during your consultation to ensure that you understand and are satisfied with the treatment plan.
For further information please refer to other information pages including: ‘Thyroid, ‘Salivary Glands’ and ‘Lymph Nodes’.
