Neck Lumps and Bumps - When should I be concerned?

Neck lumps (and bumps) can be a startling discovery and not uncommon. These lumps can be classified into 'superficial' lumps if they are found within the skin or 'deep' lumps if they are under the skin. Superficial lumps can arise from skin cells (epidermoid cyst), oil glands (sebaceous cyst) or fat cells in the skin layer (lipoma). These lumps are benign and may grow slowly over the years. Surgery to remove these lumps can be considered if they cause discomfort due to pressure effects. In the case of epidermoid cysts and sebaceous cysts, these lumps may get infected and progress to pus formation. Thus, surgery can help to prevent this complication.

Causes of deep lumps include thyroid nodules and enlarged lymph nodes. Most thyroid nodules are benign and rarely cause thyroid hormone imbalance. Evaluation of a thyroid nodule centres on excluding thyroid cancer and often involves an ultrasound scan and a needle biopsy. Surgery is warranted for thyroid cancer or in some situations when the needle biopsy is unable to confirm benign findings. Occasionally, surgery may be required if the nodule causes pressure Image: Shutterstock

discomfort in the neck.

Lymph nodes in the neck are part of our body's immune system. They can become swollen after a bout of infection. Such nodes usually run a limited course and return to normal size within a few weeks. Lymph nodes which persist or continue to grow can be secondary to 1) tuberculosis 2) lymphoma or 3) the spread of cancer elsewhere, eg. nose. Differentiating between the various causes of enlarged lymph nodes often require a radiological scan, tissue biopsy as well as endoscopy of the nose and throat region (naso-endoscopy).

In summary, the majority of neck lumps are harmless. However, some neck lumps can be a sign of cancer and further evaluation involves radiological scans, needle biopsy and possibly naso- endoscopy. Early diagnosis and treatment of such conditions often give a good outcome.

Dr Tan Choon Chieh
Senior Consultant
Head & Neck Service
Sengkang General Hospital