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The adult neck mass.
Eric Schwetschenau1, Daniel J Kelley
1Department of Otolaryngology and Bronchoesophagology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
American Family Physician
|September 27, 2002
Summary
Family physicians should evaluate adult neck masses by considering patient age and mass characteristics. Prompt diagnosis and appropriate imaging, such as fine-needle aspiration or CT scans, are crucial for effective management.
Area of Science:
- Family Medicine
- Otolaryngology
- Diagnostic Imaging
Background:
- Neck masses are a common clinical presentation encountered by family physicians in adult patients.
- Differential diagnosis includes inflammatory, infectious, congenital, and neoplastic causes, varying with patient age.
Purpose of the Study:
- To outline the essential steps in evaluating adult neck masses.
- To highlight key diagnostic considerations and recommended investigations.
Main Methods:
- Comprehensive medical history and thorough physical examination are foundational.
- Age, location, size, and duration of the mass are critical data points.
- Diagnostic modalities include fine-needle aspiration, biopsy, and contrast-enhanced computed tomographic (CT) scanning.
Main Results:
- Inflammatory/infectious causes (e.g., cervical adenitis) are more prevalent in younger adults.
- Congenital anomalies (e.g., branchial anomalies) and neoplastic processes are significant considerations.
- Neoplasms are more common in older adult populations.
Conclusions:
- Persistent neck masses beyond four to six weeks of antibiotic treatment warrant further investigation.
- Otolaryngology consultation for endoscopy and potential excisional biopsy is recommended for persistent masses.
- Timely and accurate diagnosis is essential for appropriate management of adult neck masses.