A lump in the neck can arise from a number of causes.  Not all neck lumps require surgery, however it is important that a neck lump be thoroughly assessed by your doctor and referred for further investigation and treatment by a specialist surgeon as required.

Common causes of a neck lump include:

• Infections caused by bacteria, viruses or other infectious organisms (enlarged lymph nodes after a viral infection)
• Inflammation for various reasons (e.g. Blocked salivary duct)
• Congenital or developmental abnormalities (thyroglossal duct cyst, branchial cyst)
• Tumours - abnormal growth of tissue that can be either benign (non-cancerous) or malignant (cancerous).

These tumours can arise from any number of structures in the neck.  Common sites are lymph nodes, the thyroid gland and salivary glands.

After a thorough clinical assessment, most patients will require further assessment of the neck lump with imaging and biopsy.  This is typically with a CT scan of the neck, but for neck lumps likely to be related to the thyroid gland, thyroid ultrasound is the modality of choice.  Biopsy refers to the removal of a sample of cells for review by a pathologist.  In the head and neck it is typically with a fine needle aspirate (FNA). 

Under ultrasound guidance, the radiologist/pathologist uses a small needle to take a sample of cells from the lump and look at it under the microscope.  Based on the cell sample, they can often give an indication as to the diagnosis and whether or not it is cancer.  Occasionally the FNA may need to be repeated if the sample was insufficient.  Once a diagnosis has been attained, your surgeon can then discuss with you the best treatment for your neck lump