1. What are the possible causes of neck lumps?
There can be several causes of a neck lump. Many causes of neck lumps depend on the location. A common neck lump encountered would be one in the centre of the neck lower down. This is commonly a thyroid lump/nodule. (see https://drdennischua.com/thyroid-head-and-neck/)
Picture of a elderly gentleman with a large thyroid nodule. The risk of a thyroid lump being cancerous is higher in a male compared with a female. Investigations to further check on this thyroid lump will include a blood test for thyroid hormones, ultrasound thyroid scan and fine needle aspiration cytology (biopsy).
A thyroid lump is commonly encountered especially in females. It can be benign or malignant (cancerous). Thyroid cancer is the 8th most common cancer affecting females in Singapore. The incidence of thyroid cancer is also increasing in Singapore. Most thyroid lumps will have to be evaluated with a thyroid hormone blood test along with a detailed ultrasound scan of the neck. If necessary, a fine needle aspiration biopsy of the nodule may have to be performed to determine its nature.
Other causes of neck lumps may be from a reactive cervical lymphadenopathy. These neck lumps are commonly located at the side of the neck. There are about 600-800 lymph nodes in one’s body. Lymph nodes play an important role in our immune system so its normal to have them! Most are not palpable unless they are enlarged.
Most lymph nodal enlargements are related to infection or inflammatory causes. Thankfully most are not due to lymphoma. It is important to get a thorough check inside the nasal cavity and oral cavity when one encounters a lymph node enlargement. This is to ensure there are no tumors within these cavities that can result in a lymph node enlargements. The treatment for a reactive cervical lymphadenopathy is a trial of oral antibiotics. If it does not resolve it needs further assessment. Generally, any lymph nodes that is larger than 2cm, persists for more than 2 weeks, feels rubbery or hard needs a thorough assessment. A fine needle aspiration biopsy can be performed in the clinic to evaluate it further.
Picture of large neck lumps on both sides of the neck that grew rapidly over 2 months. This neck lump was hard and painless. Biopsy of this lump eventually revealed this to be a spread from lung cancer to the lymph nodes of the neck.
Salivary gland enlargements either from sialadenitis (infection) or tumors are sometimes encountered that can result in a neck lump. An infected salivary gland is usually painful that is worsened upon eating whilst a salivary gland tumor frequently feels hard and is painless.
Here with Dr Dennis Chua, he is also accredited to perform sialendoscopy, a minimally invasive technique to treat salivary gland stones or infection further.
2. When should I be worried about a neck lump? How does a cancerous neck lump feel?
There are certain red flags about neck lumps that should worry us. If the neck lump has persisted beyond 2 weeks, increasing in size, larger than 2cm and feels hard and fixated, this needs to be assessed further.
3. How do I get a neck lump thoroughly assessed? What doctor should I see for a neck lump?
If your neck lump has persisted beyond 2 weeks, you should get it checked out with an Ear Nose Throat (ENT) Otolaryngologist specialist.
Examination may include a gentle nasoendoscopy to check the nasal and oral cavity thoroughly. Blood tests or ultrasound scans may be necessary depending on the findings. The good news is 19 out of 20 individuals with neck lumps should have good news! (ie not cancerous)
4. Can a neck lump be caused by stress?
Most neck lumps are not related to stress. However excessive stress can weaken the immune system and result in you being susceptible to infections. Stress hormones produced by the body such as cortisol act like steroids which can affect the immune system function.
Always boost your immune system with good sleep, nutrition and some exercise regularly.
Picture of a patient with a postauricular (behind the ear) lump. Excision biopsy proved this to be a salivary gland tumor (pleomorphic adenoma). The patient was cured completely and successfully after removal of this tumor.
Here with Dr. Dennis Chua at ENT Surgeons Medical Centre at Mount Elizabeth Orchard, evaluation of a neck lump can be done conveniently and painlessly. If a needle biopsy is needed, local anaesthesia is used and this is usually a pain-free process. This is done in the clinic setting, takes about 10 minutes and the patient can return to work after the clinic consult. Further treatment will depend on the result of the biopsy. Most neck lumps do not require major surgery.
As Dr Dennis Chua is medisave accredited, most procedures such as a nasoendoscopy or needle biopsy are insurance and medisave claimable. Our staff can help explain the claims process to you further.