How to (and how not to) manage the patient with a lump in the neck

In the management of a patient with an isolated lump in the neck, knowing what actions should not be taken is as crucial as knowing what should be done. A careful history and physical examination as well as guidelines such as the low prevalence of malignant lesions in children but the high prevalence in adults can aid the primary physician in reaching an accurate diagnosis. An extensive radiographic work-up, and possible peroral panendoscopy, may be required when malignancy is suspected but undiagnosed in adults. Biopsy of the mass itself should only be done as a last resort.