The Adult Neck Mass: Predictors of Malignancy

Area of Science:

• Otolaryngology
• Oncology
• Medical Informatics

Background:

• Distinguishing benign from malignant adult neck masses is clinically challenging.
• Limited data exists to guide risk assessment for neck masses.

Purpose of the Study:

• To identify patient and mass-related factors associated with malignancy in adult neck masses.
• To improve risk stratification for adult neck masses.

Main Methods:

• Retrospective cohort study of 4103 adult patients referred for neck masses.
• Bivariate and multivariable logistic regression analyses were performed to assess malignancy risk factors.

Main Results:

• Malignancy was diagnosed in 5.0% of patients.
• Factors associated with malignancy included male sex (aOR=2.38), increasing age (8.4% in patients ≥70 years), White non-Hispanic ethnicity (aOR=1.75), larger minimum mass dimension (≥1.5 cm, aOR=3.87), multiple masses (aOR=5.07), and heterogeneous/ill-defined mass quality (aOR=2.57).

Conclusions:

• Most referred neck masses are benign.
• Age, sex, ethnicity, and specific mass characteristics (size, multiplicity, imaging quality) are significant predictors of malignancy.