Neck Lump – Ear, Nose, and Throat Disorders

By

Marvin P. Fried

, MD, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine

Reviewed/Revised May 2023

VIEW PROFESSIONAL VERSION

People may discover an abnormal lump (mas) in their neck. Sometimes, doctors discover a neck lump during an examination. Neck lumps may be painful or painless depending on what has caused them. Painless neck lumps may be present for a long time before people notice them.

Most neck lumps are enlarged lymph nodes Enlarged lymph nodes due to infections People may discover an abnormal lump (mas) in their neck. Sometimes, doctors discover a neck lump during an examination. Neck lumps may be painful or painless depending on what has caused them… read more . Sometimes, the lump is a congenital cyst, an enlarged salivary gland, or an enlarged thyroid gland.

The most common causes of enlarged lymph nodes among younger people include the following:

• Reaction to nearby infection (such as a cold or a throat infection)

• Direct bacterial infection of a lymph node

• Certain bodywide (systemic) infections

One or more neck lymph nodes often enlarge in response to an upper respiratory infection, throat infection, or dental infection. In such cases,the nodes are soft and usually not tender. They typically return to normal shortly after the infection goes away.

Sometimes bacteria can directly infect a lymph node (called lymphadenitis Lymphadenitis Lymphadenitis is infection of one or more lymph nodes, which usually become swollen and tender. (See also Overview of Bacterial Skin Infections.) Lymph is a fluid that oozes out of the body’s… read more ). These infection include cat-scratch disease Cat-Scratch Disease Cat-scratch disease is infection caused by the gram-negative bacteria Bartonella henselae and transmitted by a scratch or bite from an infected cat, often causing a crusted bump and swollen. .. read more , toxoplasmosis Toxoplasmosis Toxoplasmosis is infection caused by the protozoan parasite Toxoplasma gondii. Infection occurs when people unknowingly ingest toxoplasma cysts from cat feces or eat contaminated meat… read more , and actinomycosis Actinomycosis Actinomycosis is a chronic infection caused mainly by the anaerobic bacteria Actinomyces israelii. This species of bacteria normally resides in the crevices between the teeth and gums… read more . In such infections, the infected nodes are quite tender to the touch.

Certain systemic infections typically cause several lymph nodes to enlarge, including some in the neck. The most common of these infections are mononucleosis Infectious Mononucleosis Epstein-Barr virus causes a number of diseases, including infectious mononucleosis. The virus is spread through kissing. Symptoms vary, but the most common are extreme fatigue, fever, sore throat… read more , human immunodeficiency virus Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and is treated with antiretroviral medications. If untreated, it can cause… read more (HIV), and tuberculosis Tuberculosis (TB) Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs, but almost any organ can be involved. Tuberculosis… read more .

A much less common but more serious cause of enlarged lymph nodes is

• Cancer

Cancerous (malignant) neck lumps are more common among older people, but they may occur in younger people. The cancerous lump may be any of the following:

• A cancer of a nearby structure, such as the mouth or throat, that has grown into the neck

• A cancerous lymph node, which may occur when a cancer spreads (metastasizes) from a nearby structure or from more distant parts of the body

• A cancer that begins in the lymphatic system (lymphoma Overview of Lymphoma Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs. Lymphomas are cancers of a specific type of white blood cells known as lymphocytes. These… read more ).

Cancerous lumps are not painful or tender to the touch and often are rock-hard.

Cysts are hollow, fluid-filled masses that are usually harmless unless they become infected. Some cysts in the neck are present from birth because of abnormalities that occurred during fetal development. Sometimes cysts develop in the skin (epidermoid cyst Cutaneous Cysts Cutaneous cysts are common, slow-growing lumps. Epidermal inclusion cysts are the most common cutaneous cysts. (See also Overview of Skin Growths.) Epidermal inclusion cysts (epidermoid cysts)… read more ), including in the skin of the neck.

A salivary gland under the jaw (submandibular gland Salivary gland swelling Salivary glands produce saliva, which moistens food to make it easy to swallow and contains enzymes (proteins) to help break down food so it is easier to digest. Salivary glands can malfunction. .. read more ) can enlarge if it is blocked by a stone or becomes infected or if cancer develops in it.

The thyroid gland, which is in the middle of the neck just above the breastbone, can enlarge. The most common type of enlargement is goiter Simple Nontoxic Goiter Simple nontoxic goiter is noncancerous enlargement of the thyroid gland that does not involve over- or underproduction of thyroid hormones. Noncancerous thyroid enlargement can occur because… read more , which is noncancerous (benign). Thyroid cancer and thyroid inflammation (thyroiditis) are less common.

The following information can help people decide whether a doctor’s evaluation is needed and help them know what to expect during the evaluation.

In people with a neck lump, certain symptoms and characteristics are cause for concern. They include

• A very hard lump

• Sores or growths in the mouth

• Difficulty swallowing and/or hoarseness

• A new lump or lumps in an older person

In general, painless lumps are somewhat more worrisome than painful ones.

People who have any type of neck lump for more than a few days should see a doctor, particularly people with warning signs. People with other symptoms (such as fever) should see a doctor as soon as possible.

Doctors ask questions about the person’s symptoms and medical history and do a physical examination. What doctors find during the history and physical examination helps decide what, if any, tests need to be done.

During the medical history, doctors ask about the following:

• Symptoms of colds (such as a sore throat, sneezing, and a runny nose), and throat infections (such as pain when swallowing), and dental infections (such as toothache)

• Symptoms of cancer in the neck (such as difficulty speaking or swallowing) as well as risk factors for cancer, particularly smoking and drinking alcohol

• Risk factors for HIV and tuberculosis infection

During the physical examination, doctors focus on the ears, nose, and throat (including the tonsils, base of the tongue, and thyroid and salivary glands). They look for signs of infection or abnormal growths, including looking down the throat with a mirror or a thin flexible viewing tube (laryngoscopy). They also feel the neck lump or lumps to determine whether the lump is soft, rubbery or hard and whether it is tender.

If there is an obvious source of infection (such as a cold or a sore throat) or if the person is young and healthy and has a tender lump present for only a few days, no tests are needed immediately. Such people are watched closely to see whether the lump goes away without treatment. If it does not go away, tests are needed.

Most other people should have a complete blood count (CBC) and a chest x-ray Plain X-Rays X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high… read more . If younger people have no risk factors for cancer or findings that suggest cancer (such as mouth growths), imaging tests are often done, sometimes followed by biopsy. For older people, particularly those with warning signs or risk factors for cancer, doctors often do several tests to look for a source of cancer before they remove a piece of the lump (a needle biopsy) or the entire lump for testing (an excisional biopsy). Tests often include blood tests and computed tomography Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually… read more (CT) or magnetic resonance imaging Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe… read more (MRI) of the head and neck. Ultrasonography Ultrasonography Ultrasonography uses high-frequency sound (ultrasound) waves to produce images of internal organs and other tissues. A device called a transducer converts electrical current into sound waves… read more is preferred for children to avoid radiation exposure and may be used in adults if doctors suspect a thyroid mass. In children, infection is the most common cause of neck lumps, So before an imaging test is done, children are usually first given antibiotics to see if the lumps go away.

To look for cancer originating in other parts of the body, doctors usually take x-rays of the upper digestive tract, a thyroid scan, and a CT scan of the chest. Direct examination of the larynx (laryngoscopy), lungs (bronchoscopy), and esophagus (esophagoscopy) with biopsies, done at the same time, may be needed.

Doctors treat the cause of the neck mass.

If the lump is a lymph node enlarged because of an infection, the lump usually goes away after the infection has resolved.

When cancer cells are found in a lump or an enlarged lymph node in the neck and there are no signs of cancer anywhere else, the entire lump or lymph node containing the cancer cells is removed along with additional lymph nodes and fatty tissue within the neck. If the tumor is large, doctors may also remove the internal jugular vein, along with nearby muscles and nerves. Radiation therapy is often given as well.

• Most neck lumps are enlarged lymph nodes.

• Painless lumps are somewhat more worrisome than painful ones.

• Usually testing is not needed unless the doctor suspects cancer.

• Cancerous neck lumps are removed surgically if there are no signs of cancer elsewhere in the body..

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Pictures, Causes, Associated Symptoms, and More

A lump on your neck can result from a viral infection or a benign growth. But sometimes it may indicate an underlying condition.

A lump on the neck is also called a neck mass. Neck lumps or masses can be large and visible, or they can be very small. Most neck lumps aren’t harmful. Most are also benign, or noncancerous. But a neck lump can also be a sign of a serious condition, such as an infection or a cancerous growth.

If you have a neck lump, your healthcare provider should evaluate it promptly. See your healthcare provider right away if you have an unexplained neck mass.

Many conditions can cause neck lumps. Here is a list of 19 possible causes.

Warning graphic images ahead.

Infectious mononucleosis

Share on PinterestImage by: James Heilman, MD (Own work) [CC BY-SA 3.0 (https://creativecommons. org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

• Infectious mononucleosis is usually caused by the Epstein-Barr virus (EBV)
• It mainly occurs in high school and college students
• Symptoms include fever, swollen lymph glands, sore throat, headache, fatigue, night sweats, and body aches
• Symptoms may last for up to 2 months

Read full article on infectious mononucleosis.

Thyroid nodules

Share on PinterestImage by: Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons

• These are solid or fluid-filled lumps that develop in the thyroid gland
• They’re classified as cold, warm, or hot, depending on whether they produce thyroid hormones or not
• Thyroid nodules are usually harmless, but may be a sign of disease like cancer or autoimmune dysfunction
• Swollen or lumpy thyroid gland, cough, hoarse voice, pain in the throat or neck, difficulty swallowing or breathing are possible symptoms
• Symptoms can indicate an overactive thyroid (hyperthyroid) or underactive thyroid (hypothyroid)

Read full article on thyroid nodules.

Branchial cleft cyst

Share on PinterestImage by: BigBill58 (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

• Branchial cleft cyst is a type of birth defect in which a lump develops on one or both sides of a child’s neck or below the collarbone.
• It occurs during embryonic development when tissues in the neck and collarbone, or branchial cleft, don’t develop normally.
• In most cases, a branchial cleft cyst isn’t dangerous, but it may cause skin irritation or infection and, in rare cases, cancer.
• Signs include a dimple, lump, or skin tag on your child’s neck, upper shoulder, or slightly below their collarbone.
• Other signs include fluid draining from your child’s neck, and swelling or tenderness that usually occurs with an upper respiratory infection.

Read full article on branchial cleft cysts.

Goiter

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• A goiter is an abnormal growth of the thyroid gland
• It may be benign or associated with increases or decreases in thyroid hormone
• Goiters may be nodular or diffuse
• Enlargement may cause difficulty swallowing or breathing, coughing, hoarseness, or dizziness when you raise your arm above your head

Read full article on goiters.

Tonsillitis

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• This is a viral or bacterial infection of the tonsil lymph nodes
• Symptoms include sore throat, difficulty swallowing, fever, chills, headache, bad breath
• Swollen, tender tonsils and white or yellow spots on tonsils may also occur

Read full article on tonsillitis.

Hodgkin’s disease

• The most common symptom is painless swelling of the lymph nodes
• Hodgkins disease may cause night sweats, itchy skin, or unexplained fever
• Fatigue, unintended weight loss, or persistent cough are other symptoms

Read full article on hodgkin’s disease.

Non-Hodgkin’s lymphoma

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• Non-Hodgkin’s lymphoma is a diverse group of white blood cell cancers
• Classic B symptoms include fever, night sweats, and unintentional weight loss
• Other possible symptoms include painless, swollen lymph nodes, enlarged liver, enlarged spleen, skin rash, itching, fatigue, and abdominal swelling

Read full article on non-Hodgkin’s lymphoma.

Thyroid cancer

• This cancer occurs when normal cells in the thyroid become abnormal and start to grow out of control
• It’s the most common form of endocrine cancer with multiple subtypes
• Symptoms include lump in the throat, cough, hoarse voice, pain in the throat or neck, difficulty swallowing, swollen lymph nodes in neck, swollen or lumpy thyroid gland

Read full article on thyroid cancer.

Swollen lymph nodes

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• Lymph nodes become swollen in response to illness, infection, medications, and stress, or, more rarely, cancer and autoimmune disease
• Swollen nodes may be tender or painless, and located in one or more places throughout the body
• Small, firm, bean-shaped lumps appear in the armpits, under the jaw, on the sides of the neck, in the groin, or above the collarbone
• Lymph nodes are considered swollen when they are larger than 1 to 2 cm in size

Read full article on swollen lymph nodes.

Lipoma

• Soft to the touch and moves easily if prodded with your finger
• Small, just under the skin, and pale or colorless
• Commonly located in the neck, back, or shoulders
• Only painful if it grows into nerves

Read full article on lipoma.

Mumps

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• Mumps is an extremely contagious disease caused by the mumps virus It spreads by saliva, nasal secretions, and close personal contact with infected people
• Fever, fatigue, body aches, headache and loss of appetite are common
• Inflammation of the salivary (parotid) glands causes swelling, pressure, and pain in the cheeks
• Complications of infection include inflammation of the testicles (orchitis), inflammation of the ovaries, meningitis, encephalitis, pancreatitis, and permanent hearing loss
• Vaccination protects against mumps infection and mumps complications

Read full article on mumps.

Bacterial pharyngitis

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• Bacterial pharyngitis is inflammation in the back of the throat caused by a bacterial or viral infection
• It causes a sore, dry, or scratchy throat accompanied by other symptoms such as fever, chills, body aches, nasal congestion, swollen lymph nodes, headache, cough, fatigue, or nausea
• The duration of symptoms depends on the cause of the infection

Read full article on bacterial pharyngitis.

Throat cancer

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• This encompasses cancer of the voice box, the vocal cords, and other parts of the throat, such as the tonsils and oropharynx
• It may occur in the form of squamous cell carcinoma or adenocarcinoma
• Symptoms include voice changes, difficulty swallowing, weight loss, sore throat, cough, swollen lymph nodes, and wheezing
• It’s most common in people with a history of smoking, excessive alcohol use, vitamin A deficiency, exposure to asbestos, oral HPV, and poor dental hygiene

Read full article on throat cancer.

Actinic keratosis

• Typically less than 2 cm, or about the size of a pencil eraser
• Thick, scaly, or crusty skin patch
• Appears on parts of the body that receive a lot of sun exposure (hands, arms, face, scalp, and neck)
• Usually pink in color but can have a brown, tan, or gray base

Read full article on actinic keratosis.

Basal cell carcinoma

• Raised, firm, and pale areas that may resemble a scar
• Dome-like, pink or red, shiny, and pearly areas that may have a sunk-in center, like a crater
• Visible blood vessels on the growth
• Easy bleeding or oozing wound that doesn’t seem to heal, or heals and then reappears

Read full article on basal cell carcinoma.

Squamous cell carcinoma

• Often occurs in areas exposed to UV radiation, such as the face, ears, and back of the hands
• Scaly, reddish patch of skin progresses to a raised bump that continues to grow
• Growth that bleeds easily and doesn’t heal, or heals and then reappears

Read full article on squamous cell carcinoma.

Melanoma

• The most serious form of skin cancer, more common in fair-skinned people
• Mole anywhere on the body that has irregularly shaped edges, asymmetrical shape, and multiple colors
• Mole that has changed color or gotten bigger over time
• Usually larger than a pencil eraser

Read full article on melanoma.

Rubella

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• This viral infection is also known as German measles
• A pink or red rash begins on the face and then spreads downward to the rest of the body
• Mild fever, swollen and tender lymph nodes, runny or stuffy nose, headache, muscle pain, inflamed or red eyes are some symptoms
• Rubella is a serious condition in pregnant women, as it may cause congenital rubella syndrome in the fetus
• It’s prevented by receiving normal childhood vaccinations

Read full article on rubella.

Cat-scratch fever

• This disease is contracted from the bites and scratches of cats infected with Bartonella henselae bacteria
• A bump or blister appears at the bite or scratch site
• Swollen lymph nodes near the bite or scratch site Low fever, fatigue, headache, body aches are some of its symptoms

Read full article on cat-scratch fever.

A lump in the neck can be hard or soft, tender or non-tender. Lumps can be located in or under the skin, as in a sebaceous cyst, cystic acne, or lipoma. A lipoma is a benign fatty growth. A lump may also come from tissues and organs within your neck.

Where the lump originates plays an important role in determining what it is. Because there are many muscles, tissues, and organs near the neck, there are many places neck lumps can originate, including:

• the lymph nodes
• the thyroid gland
• parathyroid glands, which are four small glands located behind the thyroid gland
• recurrent laryngeal nerves, which enable movement of the vocal cords
• neck muscles
• the trachea, or windpipe
• the larynx, or voice box
• cervical vertebrae
• nerves of the sympathetic and parasympathetic nervous system
• the brachial plexus, which is a series of nerves that supply your upper limbs and trapezius muscle
• salivary glands
• various arteries and veins

An enlarged lymph node is the most common cause of a neck lump. Lymph nodes contain cells that help your body fight off infections and attack malignant cells, or cancer. When you’re sick, your lymph nodes can become enlarged to help fight the infection. Other common causes of enlarged lymph nodes include:

• ear infections
• sinus infections
• tonsillitis
• strep throat
• dental infections
• bacterial infections of the scalp

There are other illnesses that can cause a neck lump:

• Autoimmune diseases, cancer, and other disorders of the thyroid gland, such as goiter due to iodine deficiency, can cause enlargement of part or all of your thyroid gland.
• Viruses, such as mumps, can make your salivary glands enlarged.
• Injury or torticollis can cause a lump in your neck muscles.

Cancer

Most neck lumps are benign, but cancer is a possible cause. For adults, the chance that a neck lump is cancerous increases after the age of 50, according to the Cleveland Clinic. Lifestyle choices, such as smoking and drinking, can also have an impact.

Prolonged use of tobacco and alcohol are the two greatest risk factors for cancers of the mouth and throat, according to the American Cancer Society (ACS). Another common risk factor for cancers of the neck, throat, and mouth is a human papillomavirus (HPV) infection. This infection is generally transmitted sexually, and it’s very common. The ACS states that signs of an HPV infection are now found in two-thirds of all throat cancers.

Cancers that show up as a lump in the neck could include:

• thyroid cancer
• cancers of the head and neck tissues
• Hodgkin’s lymphoma
• non-Hodgkin’s lymphoma
• leukemia
• other types of cancer, including lung, throat, and breast cancer
• forms of skin cancer, such as actinic keratosis, basal cell carcinoma, squamous cell carcinoma, and melanoma

Viruses

When we think of viruses, we commonly think of the common cold and the flu. However, there are plenty of other viruses that can infect humans, many of which can cause a lump in the neck. These include:

• HIV
• herpes simplex
• infectious mononucleosis, or mono
• rubella
• viral pharyngitis

Bacteria

A bacterial infection can cause neck and throat problems, leading to inflammation and a neck lump. They include:

• infection from atypical mycobacterium, a type of bacteria most common in people with compromised immune systems and lung disease
• cat scratch fever
• peritonsillar abscess, which is an abscess on or near the tonsils
• strep throat
• tonsillitis
• tuberculosis
• bacterial pharyngitis

Many of these infections may be treated with prescription antibiotics.

Other possible causes

Neck lumps might also be caused by lipomas, which develop under the skin. They may also be caused by a branchial cleft cyst or thyroid nodules.

There are other, less common causes of neck lumps. Allergic reactions to medication and food can cause neck lumps. A stone in the salivary duct, which can block saliva, can also cause a neck lump.

Because a neck lump can be caused by such a variety of conditions and diseases, there can be many other related symptoms. Some people will have no symptoms. Others will have some symptoms related to the condition that’s causing the neck lump.

If your neck lump is caused by an infection and your lymph nodes are enlarged, you might also have a sore throat, difficulty swallowing, or pain in the ear. If your neck lump is blocking your airway, you might also have trouble breathing or sound hoarse when you speak.

Sometimes people with neck lumps that are caused by cancer have skin changes around the area. They may also have blood or phlegm in their saliva.

Your healthcare provider will likely want to ask you about your health history, including details about your lifestyle habits and your symptoms. Your healthcare provider will want to know how long you’ve been smoking or drinking and how much you smoke or drink on a daily basis. They’ll also want to know when your symptoms started and how severe they are. This will be followed by a physical exam.

During the physical exam, your healthcare provider will carefully examine your:

• scalp
• ears
• eyes
• nose
• mouth
• throat
• neck

They will also look for any abnormal skin changes and other related symptoms.

Your diagnosis will be based on your symptoms, history, and the results of the physical exam. In some cases, your healthcare provider may refer you to an ear, nose, and throat (ENT) specialist for a detailed evaluation of those body parts as well as your sinuses.

The ENT specialist may perform an oto-rhino-laryngoscopy. During this procedure, they’ll use a lighted instrument to see areas of your ears, nose, and throat that aren’t otherwise visible. This evaluation doesn’t require general anesthesia, so you’ll be awake during the procedure.

Your healthcare provider and any specialist may run a variety of tests to determine the cause of your neck lump. A complete blood count (CBC) can be performed to evaluate your overall general health and provide insight into a number of possible conditions. For instance, your white blood cell (WBC) count may be high if you have an infection.

Other possible tests include:

• sinus X-rays
• chest X-ray, which allows your healthcare provider to see if there’s a problem in your lungs, trachea, or chest lymph nodes
• ultrasound of the neck, which is a noninvasive test that uses sound waves to evaluate neck lumps
• MRI of the head and neck, which makes detailed images of the structures in your head and neck

You can connect to an ENT specialist in your area using the Healthline FindCare tool.

The type of treatment for a neck lump depends on the underlying cause. Lumps caused by bacterial infections are treated with antibiotics. Treatment options for cancer of the head and neck include surgery, radiation, and chemotherapy.

Early detection is the key to successful treatment of the underlying cause of a neck lump. According to the American Academy of Otolaryngology — Head and Neck Surgery, most cancers of the head and neck can be cured with few side effects if they’re detected early.

Neck lumps can happen to anyone, and they’re not always signs of a serious health issue. However, if you have a neck lump, it’s important to see your healthcare provider to be sure. Like all illnesses, it’s better to get a diagnosis and treatment as early as possible, especially if your neck lump does turn out to be caused by something serious.

Read this article in Spanish

removal operation in Moscow at the FSCC FMBA of Russia

Lateral cyst of the neck (branchiogenic tumor) is a benign tumor-like formation, which is covered with a capsule on the outside, and contains a cavity with liquid contents inside. Lateral cysts of the neck are a congenital pathology. The main mechanism of its formation is a violation of the laying of organs and tissues in the embryo.

Lateral cysts are located in the so-called “sleepy triangle” – anterior to the sternocleidomastoid muscle, along its inner edge, in the upper third of the neck near the angle of the lower jaw.

Lateral cysts are often asymptomatic. Symptoms appear with inflammation (suppuration) of the lateral cysts, or with large sizes, when the lateral formation compresses the main vessels and nerves of the neck. With inflamed lateral cysts, patients note pain, swelling and redness of the skin on the neck. Patients may also report difficulty or discomfort when swallowing. But most often, patients notice a nodular formation (“bump”) on the neck, as a rule, when turning the head in the opposite direction.

For the diagnosis of lateral cysts of the neck, an integrated approach is required using MRI / CT of the neck with intravenous contrast, ultrasound of the soft tissues of the neck, as well as a fine-needle aspiration biopsy for cytological examination to confirm the diagnosis.

Indications for surgery

– Lateral cysts of the neck

How to prepare

Removal of the lateral cyst of the neck is preceded by a consultation with a doctor of the head and neck pathology department, standard laboratory and instrumental diagnostics, as well as CT with contrast or MRI of the neck, ultrasound of the soft tissues of the neck, fine-needle aspiration biopsy followed by cytological examination.

It is recommended to inform the surgeon about the medications taken and about intolerance (allergic reactions) to medications. It is necessary to stop taking blood-thinning drugs a few days before surgery in agreement with the cardiologist, since the risk of bleeding increases while taking these drugs.

In general, preoperative preparation is aimed at ensuring patient safety, successful surgical treatment and reducing the risk of postoperative complications.

How is the operation

Treatment of lateral cysts of the neck is carried out only surgically. In order to avoid complications in the form of suppuration or compression of the main vessels and nerves of the neck, it is better to remove the lateral cyst as early as possible.

The operation takes place under general anesthesia. The duration of the surgical intervention is about 60 minutes and depends on the localization of the lateral cyst, the complexity of the particular case. The surgeon makes an incision on the skin of the neck along one of the skin folds in such a way that no rough scars remain after the operation. Next, the neoplasm is isolated from the surrounding tissues and removed. The surgical wound is sutured with a cosmetic suture.

Contraindications for surgery

There are no absolute contraindications for surgical treatment.

Possible complications

Infection of the postoperative wound in case of removal of an inflamed lateral cyst

Recovery after surgery

At the end of the operation, the patient is given antibacterial, anti-inflammatory treatment.

The length of stay in the hospital depends on the type of operation, but usually does not exceed 3 days.

The doctor will schedule a follow-up visit to change the bandage, examine the postoperative sutures, monitor the condition, and remove the sutures.

After removal of the lateral cyst, there may be a feeling of pain, discomfort, and general malaise. Over-the-counter pain medications prescribed by your doctor can be used to relieve symptoms.

Treatment at the FSCC

Surgeons-oncologists / maxillofacial surgeons of the Federal Scientific Clinical Center treat patients with various pathologies of the head and neck organs. The advanced equipment of the department, the laboratory and instrumental capabilities of the medical center, many years of clinical experience of specialists are the factors that ensure the high-quality performance of surgical treatment, as well as monitoring the condition after surgery and timely correction of possible complications.

Clinical case in the Head and Neck Pathology Department of the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia

Patient M., 63 years old, in February 2023, sought medical help from the specialists of the Department of Head and Neck Pathology of the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia with a complaint of a formation on the right neck and a feeling of pressure. According to the patient, the formation appeared in September 2022, a gradual increase was noted. Repeatedly applied to doctors in other medical institutions, was sent to the FSCC FMBA of Russia for a consultation.

On examination, the contours of the face are asymmetric due to a volumetric formation in the region of the angle of the lower jaw on the right, on palpation of a soft consistency, painless. On examination, the lumen of the pharynx is narrowed to 1/2 due to volume formation from the outside.

According to MRI data from 02/05/2023: In the right parapharyngeal space, there is a large cystic-solid formation with a clear uneven contour of irregular shape measuring 68x75x48 mm. Laterally, the formation spreads towards the parotid and carotid space, causing compression of the structures passing there. After MRI examination and ultrasound of the neck was diagnosed with “Lateral cyst of the neck”.

Next, surgical treatment was performed in the amount of removal of the lateral cyst.

The patient was discharged on the 3rd day after surgical treatment

Median cyst of the neck in adults and children – treatment and removal

The Center for Maxillofacial Surgery and Implantology specializes in the treatment of benign formations and has a modern hospital where operations are performed to remove them.

What is a median cyst of the neck

Median cyst of the neck in adults and children is a benign neoplasm. In general terms, it is located on the front surface of the neck and is a rounded formation that noticeably shifts when swallowing. The cyst grows slowly, has a smooth elastic surface, and its treatment requires surgical intervention.

Cyst refers to the number of congenital pathologies that occur as a result of a violation of the normal embryonic development of the fetus. Its occurrence is explained by genetic, hereditary reasons. A prerequisite for the growth of the median cyst of the neck may be intensive growth, frequent infectious and inflammatory diseases. Hormonal changes can provoke its growth. For example, in adolescence or menopause, a neck cyst may begin to grow and become noticeable.

First of all, it is worth noting that about 40% of cysts in the neck area are median. Its cavities are formed at the stage of embryonic development, but are not always immediately detected after the birth of the baby; often a cyst is discovered by chance at the age of 4 to 14 years, and in adulthood it can manifest itself during periods of hormonal changes in the body. After the diagnosis is made, it is recommended to immediately perform an operation, since it is not possible to cure such diseases with conservative methods. The operation to remove a neck cyst is quite complicated, since there are large blood vessels and nerve endings nearby. In addition, its implementation can be complicated by an already formed fistula – the direction of this duct is also laid down at the embryonic level. Congenital fistula is not an independent pathology and is always combined with cysts.

The median cyst is formed as a result of the movement of the thyroid gland rudiment along the thyroid-lingual duct from the place of its formation to the front of the neck. This happens at 6-7 weeks of pregnancy. Theoretically, this pathology can be detected by ultrasound examination already in the second month of pregnancy. In practice, a cyst can quite unexpectedly show up closer to 14-15 years.

Despite the fact that the median cyst of the neck is painless and small in size, it is not only an aesthetic defect. If you do not treat it in a timely manner, then an infection may develop and an inflammatory process begins, during which there is swelling, redness, and pain when swallowing. The most unpleasant and dangerous consequences of a cyst are suppuration and the occurrence of non-healing fistulas. If inflammation has occurred, then the treatment will be longer, therefore, if such formations are found on the neck, it is better to take the necessary measures immediately. A child with a median tumor may develop a speech disorder if it is located close to the root of the tongue.

Diagnosis

Neck cysts are painless, firm, well-demarcated lesions located in the midline on the anterior surface of the neck. They have the ability to move during swallowing, are soldered to the hyoid bone and are slightly mobile. In rare cases, cysts can be located in the lingual root, which leads to the fact that the tongue is always slightly elevated, swallowing and speech disorders often develop.

Median formations suppurate more often than lateral ones – in about 60% of cases. When infected, the cyst increases in size and becomes painful. The surrounding tissues swell, the skin turns red. When an abscess is opened, a fistula is formed with an opening located between the thyroid cartilage and the hyoid bone. If the fistula opens into the oral cavity, its mouth is located on the front surface of the tongue, on the border between its root and body.

The diagnosis is made on the basis of anamnesis and clinical data. Ultrasound and puncture with subsequent cytological examination are used as methods for instrumental diagnosis of a cyst. Puncture results in a viscous, cloudy yellowish liquid containing lymphoid elements and cells of stratified squamous epithelium. Fistulography and probing are used to study fistulous passages.

Procedure

Most neck cysts require surgical removal. Operations are indicated for formations of any size in children and with a diameter of more than one centimeter in adults. To prevent recurrence, the cyst is excised along with the capsule. The intervention is performed under intravenous anesthesia. The surgeon makes an incision over the area of ​​the tumor, highlights and removes it along with the membranes. During surgical interventions for median formations, it is also necessary to remove a part of the hyoid bone through which the cord from the tumor-like formation passes. During operations for lateral cysts, difficulties are possible due to nearby vessels and nerves.

Depending on the size, the tongue root cyst can be removed either through an incision in the skin or through the mouth. With suppuration, its complete removal is not shown. As a rule, in such cases, the cyst is opened and drained. An indication for emergency surgery is the presence of an acute inflammatory process, especially when a fistula is closed and an abscess is formed. In the future, regular dressings are carried out with washing the cyst cavity with antiseptic drugs, and anti-inflammatory therapy is prescribed. In some cases, the cavity is scarred. If this does not happen, it is removed no earlier than 2-3 months after the elimination of inflammation.

Fistulas also need to be excised and removed. This task can be associated with a number of difficulties due to the thin wall and tortuous fistula passages. Therefore, before the operation, a probe or a staining preparation is inserted into the fistulous tract. During the operation, it is necessary to remove all fistulous passages, including thin and inconspicuous ones, otherwise a recurrence is possible. The operation to excise a lateral fistula is especially difficult, since in this case the fistulous tract passes between the internal and external carotid arteries.

Removal of a cyst at the Center for Maxillofacial Surgery and Implantology

Operation on a median cyst is performed under general anesthesia in the Center’s own hospital. The treatment of a neck cyst is preceded by a mandatory ultrasound or MRI examination, as well as a thorough examination by the surgeon. The operation to remove such formations is quite complicated and requires great skill. Experienced surgeons of the Center for Maxillofacial Surgery and Implantology have extensive experience and are ready to perform an operation on a cyst of any degree of complexity. Formations without complications are removed in one visit. If the median cyst is inflamed, then the treatment consists in first cleaning it, and then, when the suppuration process is stopped, it is removed by a separate operation. After the intervention, a mandatory histological examination is carried out to determine whether there are malignant changes in the removed cysts.

The patient, as a rule, stays in the hospital after removal of the cyst for no more than a day. The recovery process is quite fast and painless. The next day after the operation, the drainage is removed (if there was no inflammatory process), and the patient can be allowed to go home. Within a month, it is necessary to limit physical activity, going to the bathhouse, sauna and taking a hot bath.