A neck mass is any abnormal lump, bump, or swelling that develops in the neck region. These masses can vary significantly in size, from small pea-sized nodules to larger, more prominent swellings. Neck masses may develop in various structures, including lymph nodes, thyroid gland, salivary glands, muscles, blood vessels, or other soft tissues of the neck. While many neck masses are benign (non-cancerous) and result from common conditions like infections or cysts, proper medical evaluation is essential, as some masses may indicate more serious underlying conditions. Professional evaluation is important for accurate diagnosis.
Neck Mass Evaluation in Singapore
Discovering a lump or swelling in your neck can be concerning, and it’s natural to feel anxious about what it might mean. A neck mass, whether painless or tender, visible or barely noticeable, requires proper medical evaluation to determine its cause and appropriate treatment. In Singapore, where access to quality healthcare is readily available, timely neck mass evaluation can provide assessment and ensure any underlying conditions are addressed appropriately. An ENT specialist can provide a comprehensive assessment using modern diagnostic techniques to identify the nature of neck masses and develop appropriate treatment plans.
*Individual results and timelines may vary.*
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
What is a Neck Mass?
Types of Neck Masses
Inflammatory/Infectious Masses
These are commonly observed neck masses, typically resulting from infections in the head and neck region. Reactive lymph nodes may swell in response to throat infections, dental problems, or systemic infections. These masses usually develop quickly and may be tender to the touch.
Congenital Masses
Present from birth but sometimes only becoming noticeable later in life, congenital masses include thyroglossal duct cysts, branchial cleft cysts, and dermoid cysts. These masses often appear along predictable anatomical locations and may fluctuate in size.
Neoplastic Masses (Tumours)
These masses can be either benign or malignant (cancerous). Benign tumours include lipomas, fibromas, and certain salivary gland tumours. Malignant masses may originate in the neck structures (primary tumours) or spread from other body parts (metastatic tumours).
Thyroid-Related Masses
Thyroid nodules and goitres represent a specific category of neck masses arising from the thyroid gland. These masses typically move with swallowing and may be associated with thyroid hormone imbalances.
Vascular Masses
Vascular masses include carotid body tumours and vascular malformations. These masses may have a pulsatile quality and require specialised imaging for diagnosis.
Causes & Risk Factors
Causes
The development of neck masses can be attributed to various underlying causes:
- Infections: Bacterial or viral infections of the throat, teeth, or scalp may cause lymph node enlargement
- Autoimmune conditions: Diseases like rheumatoid arthritis or lupus may cause persistent lymph node swelling
- Thyroid disorders: Iodine deficiency, autoimmune thyroiditis, or thyroid nodules
- Developmental abnormalities: Persistence of embryonic structures that normally disappear before birth
- Tumour growth: Abnormal cell proliferation in neck structures
- Trauma: Previous neck injury leading to scar tissue or haematoma formation
Risk Factors
Several factors may increase the likelihood of developing certain types of neck masses:
- Age: Different masses may be more common at different life stages
- Tobacco and alcohol use: Risk factors for head and neck cancers
- Previous radiation exposure: May increase risk of thyroid masses and certain cancers
- Family history: Genetic predisposition to thyroid disorders or certain cancers
- Chronic infections: Recurrent tonsillitis or dental problems
- Occupational exposures: Certain chemicals or dust particles
- Immunosuppression: Weakened immune system from medications or medical conditions
- Geographic factors: Nasopharyngeal cancer is known to occur in Southeast Asian populations
*Individual risk factors and their significance may vary. Consult a healthcare professional for a personalised assessment.*
Signs & Symptoms
Characteristics of the Mass
- Firm, hard, or rubbery consistency when touched
- Fixed or mobile nature under the skin
- Single isolated mass or multiple lumps
- Smooth or irregular surface texture
- Size changes over time
- Warmth or redness over the mass
- Pulsatile quality suggesting vascular involvement
Associated Symptoms
- Pain or tenderness in the mass or surrounding area
- Difficulty swallowing (dysphagia)
- Voice changes or hoarseness
- Breathing difficulties, especially when lying down
- Ear pain or feeling of fullness
- Unexplained weight loss
- Night sweats or persistent fever
- Persistent sore throat not responding to treatment
- Skin changes over the mass
Systemic Symptoms
- Generalised fatigue or weakness
- Loss of appetite
- Multiple swollen lymph nodes in other body regions
- Recurring infections
The pattern and combination of symptoms may provide important information about the nature of the neck mass. Rapidly growing masses with associated systemic symptoms typically require evaluation.
Experiencing these symptoms? Consider seeking medical evaluation.
Consult with an ENT specialist for proper assessment and evaluation.
When to See a Doctor
Seek immediate medical attention if you experience a neck mass with difficulty breathing, severe difficulty swallowing, or rapid growth over days to weeks. You should also seek prompt evaluation if the mass occurs with unexplained weight loss, persistent fever, night sweats, or voice changes lasting more than two weeks. Any neck mass that persists for more than two to three weeks, even without other symptoms, requires medical assessment.
During your first consultation, the ENT specialist will review your medical history, focusing on how long you’ve had the mass, associated symptoms, and relevant risk factors. A comprehensive physical examination includes careful examination of the neck mass and your throat, ears, and nasal passages. The specialist will assess the mass’s size, consistency, mobility, and relationship to surrounding structures.
Early evaluation is important as it allows for timely diagnosis and treatment when necessary. Many benign conditions may be treatable when identified early, whilst more serious conditions may have improved outcomes with prompt intervention.
Diagnosis & Testing Methods
Clinical Examination
The initial evaluation begins with a detailed physical examination. Your ENT specialist will examine the mass, noting its location, size, consistency, and mobility. Flexible nasopharyngoscopy, a thin camera examination of the throat and voice box, may be performed in the clinic to visualise areas not visible during routine examination.
Imaging Studies
Ultrasound scanning provides real-time imaging of neck masses and can distinguish solid from cystic lesions. This non-invasive test can often be performed immediately and may help guide further testing.
CT (Computed Tomography) scans offer detailed cross-sectional images, particularly useful for deep-seated masses or when assessing bone involvement.
MRI (Magnetic Resonance Imaging) provides soft tissue detail and can be valuable for evaluating complex masses or those near critical structures.
Tissue Diagnosis
Fine Needle Aspiration Cytology (FNAC) involves using a thin needle to extract cells from the mass for microscopic examination. This minimally invasive procedure can often be performed in the clinic with or without ultrasound guidance.
Core needle biopsy may be recommended when FNAC is inconclusive, providing a larger tissue sample for analysis.
Excisional biopsy, where the entire mass is surgically removed for examination, may be necessary for diagnosis in certain cases.
Blood Tests
Laboratory investigations may include complete blood count to check for infections or blood disorders, thyroid function tests for thyroid-related masses, and specific tumour markers when malignancy is suspected. These tests may provide supplementary information to guide diagnosis and treatment planning.
Treatment Options Overview
Medical Management
Antibiotic therapy may help treat bacterial infections that could cause lymph node enlargement. The choice of antibiotic depends on the suspected or confirmed pathogen. Some cases may require intravenous antibiotics initially, followed by oral therapy.
*Individual treatment duration and response may vary.*
Anti-inflammatory Medications
Non-steroidal anti-inflammatory drugs may help reduce pain and swelling associated with inflammatory masses. For certain autoimmune conditions causing neck masses, corticosteroids or immunosuppressive medications may be prescribed under careful monitoring by a healthcare professional.
Thyroid Hormone Therapy
For thyroid-related masses, hormone replacement or suppression therapy may be indicated. This treatment aims to manage certain types of thyroid nodules and associated hormonal imbalances. Regular monitoring by a healthcare professional is required for optimal management.
Minimally Invasive Procedures
- Aspiration and Drainage: Cystic masses or abscesses may be treated through needle aspiration or surgical drainage. This procedure can provide relief from pressure symptoms and allow for fluid analysis. Some cysts may require repeated aspirations or surgical treatment if they recur.
- Sclerotherapy: Selected cystic lesions can be treated with sclerosing agents injected directly into the cyst cavity. This aims to cause the cyst walls to collapse and adhere, potentially preventing fluid reaccumulation. The procedure is performed under ultrasound guidance.
- Radiofrequency Ablation: This technique uses heat generated by radiofrequency waves to target abnormal tissue. It may be considered for certain benign thyroid nodules causing symptoms or cosmetic concerns. The procedure is performed under local anaesthesia with ultrasound guidance.
Surgical Interventions
- Excisional Surgery: Complete surgical removal may be considered for many neck masses. The surgical approach depends on the mass location, size, and nature. Modern techniques aim for cosmetically acceptable incisions while ensuring complete removal.
- Lymph Node Dissection: When malignancy is confirmed, systematic removal of affected lymph nodes may be necessary. Selective neck dissection aims to preserve important structures while removing at-risk lymph node groups. The extent of surgery is tailored to the specific diagnosis and disease stage.
- Thyroidectomy: Partial or total thyroid removal may be indicated for large thyroid nodules, suspicious masses, or confirmed thyroid cancer. Minimally invasive techniques, when appropriate, may reduce recovery time and scarring.
- Endoscopic Surgery: Endoscopic techniques may allow the removal of certain neck masses through smaller incisions or natural orifices. This approach aims to reduce post-operative discomfort and improve cosmetic outcomes while maintaining surgical outcomes.
Every patient’s condition is unique.
Every patient’s condition is unique. Our ENT specialist will assess your specific situation and recommend the most suitable treatment approach for you.
Complications if Left Untreated
Untreated neck masses can lead to various complications depending on their underlying cause. Infectious masses may progress to abscess formation, potentially spreading to deep neck spaces and causing complications such as airway obstruction or mediastinitis. Chronic infections can lead to scarring and lymph node enlargement.
Undiagnosed malignant masses may grow locally, invading surrounding structures, including nerves, blood vessels, and the airway. Delayed diagnosis of cancer can impact treatment options and prognosis. Metastatic spread to distant organs may occur with time, potentially affecting treatment approaches.
Benign masses, while not immediately threatening, can cause quality-of-life issues if left untreated. Progressive growth may lead to compression of nearby structures, causing difficulty swallowing, breathing problems, or cosmetic changes. Some benign conditions may have potential for malignant transformation over time, making regular monitoring or treatment consideration advisable.
*Individual outcomes may vary. Consultation with a healthcare professional is recommended for proper evaluation and management.*
Prevention
While not all neck masses are preventable, certain measures may help reduce your risk of developing specific types. Maintaining good oral hygiene and treating dental problems promptly may help prevent lymph node infections. Regular dental check-ups and proper tooth brushing technique are preventive measures that can be considered.
Avoiding tobacco and excessive alcohol consumption may reduce the risk of head and neck cancers. These lifestyle modifications may also improve overall health and reduce the risk of various other conditions. For those who smoke, cessation programmes and support are available through various healthcare providers in Singapore.
Protecting yourself from viral infections through appropriate vaccination, including HPV vaccination, may reduce the risk of certain cancer-related neck masses. Practising safe hygiene measures, especially during flu season, may help prevent upper respiratory infections that commonly cause lymph node swelling.
Regular health screenings, particularly for those with a family history of thyroid disorders or head and neck cancers, may enable early detection of abnormalities. Workplace safety measures, including appropriate protective equipment when exposed to industrial chemicals or radiation, may help reduce occupational risk factors.
*Individual results and preventive outcomes may vary. Consult with a healthcare professional for personalised advice regarding prevention strategies.*
For Singaporeans & Singapore Permanent Residents
Medisave & Insurance Shield Plan approved
Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.
Frequently Asked Questions (FAQ)
How can I tell if a neck lump is serious?
Most neck lumps are benign, but certain features may suggest evaluation is needed. These include lumps that persist, continue growing, feel hard and fixed to surrounding tissues, or are associated with unexplained weight loss, night sweats, or voice changes. Any neck mass in adults, especially those with a smoking history, may warrant medical assessment. Only a proper medical evaluation can determine the nature of a neck mass.
Are neck masses common in children?
Neck masses in children are relatively common and usually benign. Childhood neck masses often result from reactive lymph nodes responding to infections. Congenital masses like thyroglossal duct cysts or branchial cleft cysts may become apparent during childhood. Childhood cancers causing neck masses are rare, but persistent masses may warrant medical evaluation. The approach to paediatric neck masses differs from adults, with greater emphasis on observation for reactive lymph nodes.
Can neck masses disappear on their own?
Some neck masses, particularly those caused by infections, may resolve spontaneously as the underlying infection clears. Reactive lymph nodes typically may shrink after the infection resolves. Any neck mass persisting may require medical evaluation, even if it appears to be decreasing in size. Some masses may fluctuate in size but still require treatment, making professional assessment important.
Will I have a visible scar after neck mass removal?
Modern surgical techniques aim for both complete mass removal and cosmetic outcomes. Incisions are planned along natural skin creases when possible, and closure techniques aim to minimise scarring. The final appearance depends on factors including the mass location and size, the surgical technique required, and individual healing characteristics. Scars may fade over time. Your surgeon will discuss expected cosmetic outcomes during the consultation.
*Individual results may vary.*
How often do benign neck masses become cancerous?
Most benign neck masses remain benign throughout life. Certain types have a potential for malignant transformation. For example, some thyroid nodules and specific salivary gland tumours may undergo malignant change. This risk is one reason why monitoring or removal may be recommended for certain benign masses. Regular follow-up can help detect any changes.
Can stress cause neck lumps?
Stress itself doesn’t directly cause neck masses, but it can contribute to lymph node swelling through its effect on the immune system. Stress may make you more susceptible to infections that cause reactive lymph nodes. Stress can also cause muscle tension in the neck that might be mistaken for a mass. Any persistent lump should be properly evaluated, as assuming stress as the cause may delay diagnosis of other conditions.
Conclusion
Neck mass evaluation requires a systematic approach to ensure accurate diagnosis and appropriate treatment. While discovering a neck lump can cause concern, neck masses can often be benign and treatable. The key to management lies in timely medical evaluation by a qualified specialist who can perform the necessary examinations and tests to determine the nature of your neck mass.
Our ENT specialist provides comprehensive neck mass evaluation in Singapore. Whether your neck mass requires observation, medical treatment, or surgical intervention, we aim to provide evidence-based care tailored to your specific condition and needs.
*Individual results and treatment approaches may vary.*
Take the First Step Towards Better Health
If you have concerns about a neck mass, our ENT specialist can provide a professional evaluation using current diagnostic approaches.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
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A Specialist Clinic for Sinus, Snoring & ENT
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Hospital
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