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The Work Up of Head and Neck Masses
Ogoegbunam Okolo1, Jalen Benson1, Robert Wardlow1
1Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
The Medical Clinics of North America
|November 8, 2025
Summary
Malignancy is a common cause of persistent neck masses in adults over 40. A thorough physical exam and prompt workup are crucial for diagnosing and managing these suspicious lesions.
Area of Science:
- Internal Medicine
- Otolaryngology
- Oncology
Background:
- Persistent neck masses in adults over 40 are frequently malignant.
- Suspicion is warranted until malignancy is ruled out.
- Physical examination is critical for initial diagnosis.
Purpose of the Study:
- To describe the diagnostic and treatment approach for adult neck masses.
- To provide an algorithm for managing persistent neck masses.
Main Methods:
- Review of current literature and clinical guidelines.
- Emphasis on physical examination findings (asymmetry, immobility, nontender).
- Presentation of a management algorithm for persistent neck masses.
Main Results:
- Nontender neck masses are more indicative of malignancy.
- Physical exam findings like asymmetry and immobility raise suspicion.
- An algorithm guides workup and treatment decisions.
Conclusions:
- Early and thorough evaluation is essential for persistent neck masses.
- Suspicious findings on physical exam necessitate further investigation.
- A structured approach improves management of adult neck masses.
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