A neck lump is a ‘bump’, ‘lump’ or ‘swelling’ in the neck. The presence of a lump in the neck is a common clinical problem.

Finding a lump in the neck can cause considerable anxiety. Fortunately, the majority of neck lumps are benign and not serious. However, cancers of the mouth, throat, voice box (larynx), thyroid, and some lymphomas (blood cancers) can appear first as a painless, growing neck lump. Therefore all neck lumps require timely assessment by an Ear, Nose & Throat consultant.

A lump in the neck persisting for more than three weeks, especially if it is not associated with a cold, flu, or other infection should be assessed by a specialist consultant.

There are many different causes of neck lumps and the most common are listed below:

Thyroid gland

The thyroid gland is an important hormone gland situated just below the Adam’s apple in the neck. The gland produces a hormone (thyroxine) which is essential to control the body’s metabolism and well-being.

Lumps are very commonly found within this gland. The majority of such nodules are not serious, however about 5% (1 in 20) are cancers, which is why clinical assessment and thorough investigations are required. To investigate thyroid lumps several methods can be used, most frequently an ultrasound scan is performed to assess the lump and to accurately guide a small biopsy from the lump using a fine needle.

Thyroid surgery (thyroidectomy) may be performed for various reasons: if the lump is potentially malignant, a cosmetic issue as a result of its size or if the thyroid is overactive. Surgery can be done through conventional ‘open’ surgery or endoscopically (‘keyhole’ thyroidectomy) for improved cosmetic results.

Parotid gland

The parotid gland is the largest salivary gland, positioned just below the ear and behind the jaw. It produces saliva that helps in the process of chewing foods and swallowing.

Lumps in the Parotid gland are common amongst all ages; the majority are not cancerous; however they sometimes contain cancer cells, which is why thorough investigations are recommended.

Whilst only a small number may be cancerous, benign lumps can still cause their own problems due to increasing size causing unsightly swelling and pain; stones can also form in the gland blocking the ducts which release saliva causing repeated painful swelling and infections.

Again, the most frequently used investigation is an ultrasound scan to both assess the lump and to accurately guide a small biopsy from the lump using a fine needle.

Lymph nodes

Enlargement of lymph nodes – this is the most common cause of new neck lumps. Lymph nodes are part of the immune system, and enlarge when the body rallies to fight an infection. When the infection recedes, lymph swelling should subside as well. If they remain large and especially if they continue to grow in size they require urgent assessment by an ENT Surgeon as they may be due to a cancer in the head and neck regions.