Neck masses are common in adults and can occur for many reasons. You may develop a neck mass due to a viral or bacterial infection. Ear or sinus infection, dental infection, strep throat, mumps, or a goiter may cause a neck mass. If your neck mass is from an infection, it should go away completely when the infection goes away.
Your neck mass could also be caused by a noncancerous (benign) tumor or a cancerous (malignant) tumor. Cancerous neck masses in adults are most often due to head and neck squamous cell carcinoma (HNSCC). Other causes for a neck mass may be due to cancers such as lymphoma, thyroid or salivary gland cancer, skin cancer, or cancer that has spread from somewhere else in the body.
Long-term tobacco use (cigarettes, cigars, chewing tobacco, or snuff) and alcohol use are the two most common causes of cancers of the mouth, throat, voice box, and tongue. Another common risk factor for cancers of the neck, throat, and mouth is a human papilloma virus (HPV) infection. HPV infection is usually transmitted sexually. HPV found in the mouth and throat is called “oral HPV.” Some high-risk types of oral HPV infection can cause head and neck cancers.
HNSCC of the tonsil and base of the tongue has gone up because of the increase in HPV infections. HPV-related cancers often lack the common risk factors of tobacco and alcohol use, and tend to affect younger adults. Patients with HPV-positive HNSCC may have some of the symptoms listed here, but many times a neck mass will be the only sign of this type of cancer.
When Should I See a Doctor?
See your doctor and/or an ENT (ear, nose, and throat) specialist, or otolaryngologist, if the lump in your neck lasts longer than two to three weeks. This is a persistent neck mass, which means that the lump has not gone away. You should also see a doctor if you are not sure how long you have had the neck mass because your neck mass may mean that you have a serious medical problem. If you have any of the head and neck symptoms listed above, in addition to the neck mass, you should see your doctor right away. It may not be cancer, but you need to be evaluated. Your doctor will discuss any tests needed for diagnosing your neck mass and your follow-up care.