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A neck mass or neck lump is an ambiguous mass found in the neck area. There are many different possible causes, [ 1 ] including head and neck cancer [ 2 ] and congenital conditions like branchial anomalies and thyroglossal duct cysts .
Thyroglossal duct cysts most often present with a palpable asymptomatic midline neck mass usually below [65% of the time] the level of the hyoid bone. The mass on the neck moves during swallowing or on protrusion of the tongue because of its attachment to the tongue via the tract of thyroid descent.
Cervical thymic cyst is a very rare pathology that is often incidentally found due to its asymptomatic nature. The patient usually notices a neck mass that grows slowly which triggers them to see a clinician and be admitted to the hospital. [3] However, it can cause symptoms as it grows in size and compresses on other organs.
Modified radical neck dissection. To describe the lymph nodes of the neck for neck dissection, the neck is divided into 6 areas called Levels. The levels are identified by Roman numeral, increasing towards the chest. A further Level VII to denote lymph node groups in the superior mediastinum is no longer used. Instead, lymph nodes in other non ...
In adults, healthy lymph nodes can be palpable (able to be felt), in the axilla, neck and groin. [3] In children up to the age of 12 cervical nodes up to 1 cm in size may be palpable and this may not signify any disease. [4] If nodes heal by resolution or scarring after being inflamed, they may remain palpable thereafter. [1]
In oncology, the mass typically refers to a tumor. For example, cancer of the thyroid gland may cause symptoms due to compressions of certain structures of the head and neck; pressure on the laryngeal nerves may cause voice changes, narrowing of the windpipe may cause stridor, pressure on the gullet may cause dysphagia and so on.
On MRI, ectopic cervical thymus appears as a homogeneous mass which is isointense to muscle on T1-weighted scans and hyperintense on T2-weighted scans. [3] Biopsy or histological examination upon resection can also be used to make a definitive diagnosis. [6] [9] Sometimes, ectopic thymus is found incidentally during neck surgery. [6]
The classification of the cervical lymph nodes is generally attributed to Henri Rouvière in his 1932 publication "Anatomie des Lymphatiques de l'Homme" [6] [7] Rouviere described the cervical lymph nodes as a collar which surrounded the upper aerodigestive tract, consisting of submental, facial, submandibular, parotid, mastoid, occipital and retropharyngeal nodes, together with two chains ...