![]() Nearly all thyroglossal duct cysts are below the hyoid, slightly left of midline, and seen in young people. Infrahyoid masses will be mostly thyroid in origin see Thyroid Surgery. The middle ear will always be abnormal if the cause of the abscess is mastoiditis. An abscess can develop from a necrotic node or from mastoiditis with erosion of the mastoid bone. ![]() ![]() In the post auricular area lymph nodes can be enlarged by inflammation, lymphoma or metastatic skin tumours like melanoma or SCC from the posterior scalp. These types of masses can occur anywhere in the neck and for that matter on the body. The only masses that characteristically develop in the Back of the Neck are superficial masses like lipomas and sebaceous cysts and vascular or lymphatic malformations. Lateral either, carotid/ jugular or posterior triangle including the supra-clavicular region.Anterior or midline divided into supra and infra-hyoid.There are Six general regions in the neck where lumps characteristically appear In adults a persistent lump is likely to be neoplastic and malignancy must be excluded. In Children and young adults inflammatory and congenital lumps are most common, One must always be aware that a lump may be a metastatic malignancy and that the first sign of the mass may be the primary site or vice versa. Other features that help differentiate a neck lump include: ![]() A neck lump that is hard, irregular, large, solid, fixed and non tender is likely to be malignant. Site ,size, edge, consistency, colour, attachment, transillumination, pulsation, tenderness, nodes. The features that help one diagnose neck lumps include: I have presented a systematic method of evaluating neck lumps to determine what they are most likely to be. Lumps in the neck are usually reactive neck lymph nodes or thyroid nodules but they can also, rarely, be cancer. Neck lumps are very common and they are mostly innocent. Neck Lumps Dr John Chaplin, Neck Lump Surgeon, Auckland NZ ![]()
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