The management of a neck mass: presenting feature of an asymptomatic head and neck primary malignancy?

• Published in: Annals of the Royal College of Surgeons of England Vol. 69; no. 4; pp. 181 - 184
• Main Authors: Barakat, M, Flood, L M, Oswal, V H, Ruckley, R W
• Format: Journal Article
• Language: English
• Published: England Royal College of Surgeons of England 01-07-1987
• Subjects: Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - pathology; Humans; Retrospective Studies
• ISSN: 0035-8843; 1478-7083

Malignancy of the upper aerodigestive tract is not always associated with obvious localizing symptoms. Presentation may then only be prompted by the appearance of a hard mass in the neck, a metastasis to a cervical lymph node. Neck exploration without a prior diligent search for an occult head and neck primary tumour is to be avoided as it compromises subsequent treatment. The diagnostic investigation of 112 patients complaining solely of a painless and enlarging neck swelling is reviewed. An otolaryngologic examination identified an asymptomatic malignancy of the head and neck in 72 patients (64%). Excision biopsy of the neck mass was required to achieve a diagnosis in only 29 (29%) of those patients who had not already undergone surgery. These results are presented to emphasize the need for a specialist examination of the head and neck prior to embarking on excision of any suspicious neck mass.