A number of masses may develop in your head or neck; these masses may also be called growths, tumors, lumps or bumps. While some head and neck masses are cancerous, many are not. It is important to see a physician if any abnormal bump or lump persists for more than two weeks. If a cancer is present, early detection provides the highest chance of successful treatment.
There are numerous causes of head and neck masses:
- Enlargement of lymph nodes: This is the most common cause of new neck masses. Lymph nodes, which are part of the immune system, can enlarge when the body rallies to fight an infection. When the infection recedes, lymph swelling subsides as well.
- Benign lesions: Benign masses do not spread to surrounding tissue and are not cancerous. Nevertheless, benign masses can be serious if they impact nerves or exert pressure in the head and neck, and are often removed surgically. These include cysts, thyroid masses, vascular masses, salivary gland masses and others.
- Cancers: When head and neck masses are malignant they can spread to surrounding tissue or to other parts of the body. In the head and neck, tumors may be either primary or secondary.
- Primary tumors originate in the head or neck itself, including the thyroid, throat, larynx, salivary gland, brain or other locations. Primary tumors of the head and neck typically spread to the lymph nodes in the neck. About 90 percent of head and neck cancers are caused by tobacco and alcohol use. People who have been exposed to radiation, either during medical treatments as children (common in decades past) or from nuclear radiation sources, are at considerable risk for thyroid cancer and should be screened yearly.
- Secondary cancers are tumors that have spread from primary tumors in other parts of the body to the head or neck. Most often, secondary tumors of the neck originate in the lungs, breasts, kidneys, or from skin cancers (squamous cell carcinoma or melanoma).
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 cold, flu or other infection. Cancers of the mouth, throat, larynx, thyroid and some lymphomas (blood cancers) can appear first as a painless, growing neck lump.
- Change in your voice including hoarseness that persists more than two weeks.
- Growth in the mouth.
- Swollen tongue.
- Blood in the saliva or phlegm.
- Swallowing problems.
- Persistent ear pain or ear pain while swallowing — may be a symptom of infection or a growth in the throat.
- Unexplained weight loss.
A simple examination of some masses may allow a physician to determine their cause based on location, size and consistency. In other cases, additional tests may be required. These tests include:
- MRI: Magnetic Resonance Imaging can clearly show tumors near bones, smaller tumors and brainstem masses. It uses a magnetic field rather than x-ray radiation.
- CT Scan: Computed tomography combines a sophisticated x-ray with computer technology. It is less accurate than an MRI but can help locate tumors or determine their types, detect swelling or bleeding and evaluate the effects of treatments. Injections of an iodine dye contrast material may be used to enhance the visibility of abnormal tissue during CT scans.
- PET (Positron Emission Tomography) and SPECT (Single Photon Emission Tomography): These are useful after a diagnosis to help determine the grade of a tumor or to distinguish between cancerous and dead or scar tissue. They involve injections with a radioactive tracer.
- Biopsy: A sample of tissue is taken and examined under a microscope to determine if it is malignant.
Treatments are determined by the cause of the mass. Benign neck cysts and masses are usually removed by surgical excision. Head and neck cancers may be treated by some combination of radiation therapy, chemotherapy and surgery, depending on their nature.