The Work Up of Head and Neck Masses.

Abstract

In patients over 40, malignancy is the most common cause of persistent neck masses. Until malignancy can be definitively excluded, the mass should be viewed with suspicion. A physical examination looking for asymmetry, structural abnormalities, immobile masses, or lesions is a key part of diagnosis. A nontender neck mass is more worrisome for malignancy than a tender one. This overview for internists and hospitalists describes the approach, diagnostic work up, and treatment of neck masses in adults. An algorithm is presented for the management of an adult with a persistent neck mass greater than 2 weeks.