Manchester Lumps clinic recently ran a mens health seminar covering head and neck lumps, hernias, and general body lumps.
Head and Neck Lumps
The emergence of a neck lump can be fraught with worry both for patients, parents and their clinician. We address some key questions
What are the signs of a neck lump?
There are key clinical signs to look for that can either reassure of prompt the need for an urgent specialist opinion. Neck lumps are extremely common. The commonest cause is a lymph node. Some may be related to the normal glands of the neck and others may be due to other causes. Any lump which is persistent, getting bigger or painful should be assessed.
Why do children get neck lumps and what should be done about them?
Young children have relatively immature immune systems making them prone to infections of the upper aero digestive tract, to fight these infections they develop lymphadenopathy, in the early stage of infection you will notice small enlarged lymph nodes symmetrically in the posterior triangle. Don't worry, this is completely normal, just make sure that they are under a centimetre in size, are rubbery and easily mobile. A single enlarged lymph node may be a sign of a more serious infection in a child. If it has persisted for 4 weeks you should ask for a specialist opinion; if it starts to go red and 'points' it may require drainage, both to relieve the infection and also to acquire samples to assess the causative organism.
Whats the current status of Thyroid cancer?
Whilst the prevalence of thyroid cancer is increasing, it is felt that this is due to the increased effectiveness of diagnostic tools. If you find a thyroid with a palpable or radiologically visible nodule or nodules they must undergo an ultrasound. We use a staging system called 'U staging'; this rates a nodule 1-5 with increasing change of cancer. U3 and above warrants a fine needle biopsy which in itself is graded 1-5. If there is diagnostic uncertainty a thyroid operation may be suggested or a period of monitoring. Its always useful to know a patient's thyroid function, level of calcium and their history of exposure to radiation and family history of thyroid disease.
What is throat cancer?
Throat cancer is not the commonest cancer caused by the human papillomavirus now that universal vaccination has been in place for girls to help prevent cervical cancer for over 10 years. The commonest presenting features of throat cancer are a neck lump of deep ear pain in the presence of a normal eardrum. If you discover either of these symptoms, examine the oral cavity including palpating the tongue base, floor of mouth and tonsils and seek an urgent specialist opinion. HPV has also overtaken smoking as the commonest cause of head and neck cancer. The rollout for male HPV vaccination starts in September 2019.
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for an assessment if you are concerned about a neck lump