The evaluation and management of neck masses of unknown etiology

Most neck masses appearing in adults are malignant metastases. With proper evaluation the majority of primary malignant tumors can be located. The diagnosis is obtained by assembling sufficient data in the most efficient, productive, and logical way without compromising future treatment modalities. The best selection of therapeutic methods for cure or palliation is based on the histologic features of the primary malignant tumor or its metastases and their locations. At the present time the most effective treatment for cervical metastasis from an unknown primary is a combination of wide field high dose radiation therapy and surgical resection, the exact therapeutic modality being dependent on the histologic features of the metastatic mass and its location on the neck.