Med. praxi. 2019;16(1):53-55 | DOI: 10.36290/med.2019.008

Evaluation of a neck mass in adults: suspicion of malignity

MUDr. Martin Formánek, Ph.D.^1,2, MUDr. Karol Zeleník, Ph.D.^1,2, prof. MUDr. Pavel Komínek, Ph.D., MBA^1,2

¹ Klinika otorinolaryngologie a chirurgie hlavy a krku, FN Ostrava

² Katedra kraniofaciálních oborů, Lékařská fakulta, Ostravská Univerzita

The neck mass in adults has a varied etiology. Severity varies from "banal" conditions, such as reactive lymphadenitis or lipoma, to severe malignancies such as metastasis of carcinoma originating from the mucosa of the head and neck or lymphoma. The biggest mistake is if a possible malignancy is not considered and the diagnosis is unnecessarily prolonged, which may lead to a worsening of the outcome of the treatment. Differential diagnosis and decision-making should be based on age, duration and magnitude of resistance, rate of onset, size, pain, localization, symmetry/asymmetry and other symptoms. The asymmetry must always cause suspicion of a possible tumor, and diagnosis must therefore be very rapid and targeted. We also need to think about possible malignancy in case of mass lasting for several weeks (6–7 weeks). In such cases, a specialist examination (usually ENT) is clearly indicated. Often, consultations of an infectious or hematological specialist are also needed. Sonography including fine-needle aspiration, or CT or NMR, is very helpful. However, extirpation can be in some cases the only solution leading to a definitive diagnosis.

Keywords: neck mass, management, differential diagnosis, adults

Published: February 25, 2019  Show citation