A neck mass is an irregular lump in the neck. Neck masses can present in a wide variety of sizes and forms. They can be large enough to be seen and to touch, or they may be tiny and almost imperceptible. Certain neck lumps may mean nothing more than an infection while others may involve something more serious, such as cancer.

What Causes a Neck Mass?

Neck masses are common in adults and can occur for many reasons. You may develop a neck mass due to a viral or bacterial infection. A neck mass may also stem from an ear or sinus infection, dental infection, strep throat, mumps, or a goiter. If the lump in your neck is due to an infection, the lump should disappear completely when the infection goes away.

Your neck mass could also be caused by a benign (non-cancerous) or a cancerous tumor. Cancerous or malignant neck masses in adults are most often due to head and neck squamous cell carcinoma (HNSCC), a cancer that affects the lining of the moist, mucosal surfaces inside your mouth, nose, and throat.

However, other cancers such as lymphoma, thyroid or salivary gland cancer, skin cancer, or cancer that has spread from somewhere else in the body can also provoke a lump in the neck.

I Have a Lump in My Neck: Should I See a Health Care Provider?

You should consult your healthcare provider if the mass in your neck lasts longer than 2 to 3 weeks. This is called a “persistent” neck mass, meaning the lump has not gone away. Moreover, you should see your ear, nose, and throat (ENT) physician if you’re not sure how long you have had a lump in your neck.

A mass in the neck can represent a serious medical problem and should be checked out by a qualified ENT physician. Even if the mass is not cancerous (malignant), it should still be evaluated by your healthcare provider to discuss any tests needed for diagnosing your neck mass, treatment, and follow-up care.

Be sure that your neck mass goes away completely. Follow your physician’s instructions and undergo any tests that have been ordered. Check your neck mass for any changes. Figure 1 explains how to monitor your neck mass. Keep your physician informed of your progress or if you encounter any problems.

Am I at Risk for Having a Malignant (Cancerous) Neck Mass?

Common symptoms in patients who have a neck mass with a higher risk of malignancy (cancer) include:

• The mass lasts longer than 2 to 3 weeks
• The lump gets larger
• The mass gets smaller but does not completely go away
• Voice changes
• Trouble or pain with swallowing
• Trouble hearing or ear pain on the same side as the neck mass
• Neck or throat pain
• Unexplained weight loss
• Fever higher than 101°F

Long-term tobacco use (cigarettes, cigars, chewing tobacco, or snuff) and alcohol use are the two most common causes of cancers of the mouth, throat, voice box, and tongue. Another common risk factor for cancers of the neck, throat, and mouth is a human papillomavirus (HPV) infection, which is usually transmitted sexually. HPV found in the mouth and throat is called oral HPV. Some high-risk types of oral HPV infection can cause head and neck cancers.

Cancer of the oropharynx, or tonsil and base of the tongue, has gone up because of the increase in HPV infections. HPV-related cancers often lack the common risk factors of tobacco use and drinking and tend to affect younger adults. Patients with HPV-positive head and neck squamous cell carcinoma cancer (HNSCC) may experience some of the symptoms mentioned above, but often a neck mass will be the only sign of this type of cancer.

Where Can I Get More Information?

Patients and healthcare providers should discuss all evaluation, testing, and follow-up options together to find the best approach for the patient. Printable patient handouts and materials are available that further explain neck lumps in adults and can help with discussions between patients and physicians. For more information on evaluating neck mass in adults.