How common are neck lumps and are they serious?

Neck lumps are extremely common and in the vast majority of cases are benign. They can be found anywhere on the neck, in or under the skin and may be soft or hard, asymptomatic or painful, and tender to the touch. Neck lumps have many possible causes and some can be a sign of a serious condition. A diagnosis will be made on both the features of the neck lump itself and any associated symptoms.

What symptoms can be associated with neck lumps?

Neck lumps can often appear on their own with no symptoms. Some people may have symptoms that are related to the condition that's causing the neck lump. 

Most commonly, neck lumps are the result of a swollen lymph node. Lymph nodes are found all over your neck and are part of your immune system. They often swell when you are fighting off a disease or infection, so in most cases a neck lump will occur at the same time as other symptoms of the illness you have, and disappear again once you have recovered. You won’t generally need to see a doctor to treat the lump.

However, you should seek medical help as soon as you can if you notice the following symptoms. These are signs often caused by an enlargement of the lymph node, which could block your airway:

• persistently feeling tired
• losing weight involuntarily
• difficulty swallowing
• breathlessness
• night sweats
• a hoarse voice which has lasted for more than three weeks

How does a doctor diagnose a neck lump?

You doctor will start by asking how long you have had the neck lump for and how quickly it appeared. They will ask specifically about the symptoms listed above. Next, the doctor will examine your neck to check its size, how soft or hard it is, and whether any other lumps can be detected. Depending on what the doctor suspects is causing your condition, they might examine your ears, lungs, or throat.

You might then be referred for tests, such as blood tests or imaging to see the tissues in your neck and find out the cause of the neck lump. Other tests which may be carried out include: sinus x-rays, a chest x-ray, neck ultrasound and an MRI of the head and the neck. 

What can cause a neck lump?

As already mentioned, the main cause of neck lumps is a swelling in a lymph node in response to illness, from the common cold and ear infections to chickenpox, herpes, and HIV.

Other causes of neck lumps include:

• Skin problems – abscesses, skin tags, an even acne can cause lumps in your neck. A skin rash can even affect the lymph nodes underneath the skin, causing them to swell.
• Cysts - these hollow masses filled with fluid can sometimes become infected, causing lumps in the skin or just below the skin. 
• Salivary gland problems – tubes which carry saliva to your mouth can become blocked by salivary gland stones, causing the tube to swell up. Some conditions such as mumps can cause infection in the salivary gland and swelling.
• Thyroid disorders – the thyroid gland is situated in your neck and can sometimes develop nodules or tumours. In the majority of cases these are benign, but in some cases can be a sign of thyroid cancer
• Lipomas – this is a benign tumour made of fat that grows under the skin. Lipomas can be found in the neck but are most often found in the back
• Cancer – in rare cases, swollen lymph nodes can be a sign of blood cancer, and lumps on the skin may be caused by skin cancer. Skin changes around the area and blood or phlegm in the saliva, are common symptoms of neck lumps that are due to cancer. Cancerous lumps aren't painful, but they are solid and hard. 

How do you treat a neck lump?

Treatment of neck lumps depends on the cause. For example, thyroid problems can often be tackled with hormone treatment, whereas skin tumours or lipomas are likely to require surgery and radiation therapy. If the neck lump is caused by a bacterial infection, you will be prescribed antibiotics. You will be referred to the appropriate specialist as part of the diagnostic and treatment process.

Can a neck lump grow in size? 

Lumps can sometimes grow bigger and become painful with certain activity. Unusual growth of a neck lump should be examined by a doctor. 

Can a neck lump move? 

Neck lumps that are hard and painless or persist for more than two to three weeks need medical attention. After seeking treatment, benign neck lumps will usually settle within six weeks. 

How long does a neck lump last for?

A moveable lump is a lump that you can easily move beneath the skin with your fingertips. Usually benign, it may represent a swollen lymph node which is soft, and tender or painful to the touch. 

Which specialist treats a neck lump?

Neck lumps are usually referred to an ENT specialist for a detailed evaluation of your ears, nose, throat and sinuses.