Neck mass

Background

• Common complaint seen in primary care medicine
• Important to recognize acutely life threatening etiologies, treatable disease, and potential for malignancy

Clinical Features

• Enlarged neck lesions
  • Associated symptoms based on etiology may include:
    • Pain
    • Skin changes
    • Stridor
    • Hoarseness
    • Constitutional symptoms

Differential Diagnosis

• Acute
  • Reactive lymphadenopathy
    • Viral URI
    • EBV
    • CMV
    • Strep/staph
    • HIV
    • Toxoplasmosis
    • Bartonella
    • Tuberculosis
  • Sialadenitis (can also be chronic)
  • Trauma-related
    • Hematoma
    • Pseudoaneurysm or AV fistula

• Subacute (weeks to months)
  • Cancer
    • HPV-related squamous cell carcinoma
    • Upper aerodigestive tract squamous cell carcinoma
    • Metastatic disease
    • Lymphoma
      • Hodgkin's
      • Non-hodgkin's
    • Parotid tumors
  • Amyloidosis
  • Sarcoidosis
  • Sjögren syndrome

• Chronic
  • Thyroid pathology
  • Congenital cysts
    • Branchial cleft cyst
    • Thyroglossal duct cyst
    • Dermoid cyst
  • Carotid body tumor
  • Glomus jugulare or vagale tumor
  • Laryngocele
  • Lipoma/liposarcoma
  • Parathyroid pathology