INTRODUCTION Neck masses or swellings are a common occurrence. In the adult population, approximately 75% of non-thyroid neck masses are neoplastic,1, 2 and of these 80% are metastatic. Around 75% of these metastatic neck masses are caused by a primary tumour located above the clavicle. In children under 15 years, 90% of neck masses are benign and of these up to 55% may be congenital.1, 3, 4
Benign neck masses may be classified as congenital or acquired. The latter group are often enlarged lymphadenopathy, but there may be a wide range of different pathologies involved. The introduction of fine-needle aspiration biopsy / cytology (FNAB / FNAC) with or without the use of ultrasound scan (USS) guidance has now become the gold standard investigation.5-7
The evaluation and management of patients presenting with a neck lump should include a systematic and uncompromising clinical approach.2, 8-10 This must include a thorough history, examination of the upper aerodigestive tract and head and neck, followed by relevant investigations, which may include blood tests and radiological imaging.