What to do if you have a lump on your neck!Chen Mingxu and Zhang Yanliang, attending physicians in the Department of Otolaryngology at Cathay General Hospital, Taiwan, said that the neckTumorIt can be divided into four categories: congenital diseases, inflammatory diseases, benign tumors, and malignant tumors. Except for thyroid disease, 50-80% of adult neck tumors are malignant, and 80% of malignant tumors are metastatic.cancerApproximately 80% of metastatic cancers arise from primary lesions in the head and neck. It is recommended that if people notice a tumor in the neck, they should visit an otolaryngologist as soon as possible for further investigation and treatment.
An accurate and detailed medical history can help determine whether a tumor is benign or malignant. If the patient has the following associated clinical symptoms: nose bleeding, tinnitus, hearing loss, double vision, headache (nasopharyngeal cancer); Get oral ulcers or oral masses that cannot heal. (oral cancer); Hoarseness of voice, difficulty breathing, difficulty swallowing, or pain when swallowing (throat cancer), it is necessary to suspect that a neck tumor may be malignant; In addition, if the patient has a habit of smoking for a long time, drinking excessive alcohol and chewing betel nut, all can be related to fatal diseases.
In addition, the length of time that neck tumors occur is also related to the type of disease: inflammatory diseases take on average several days, tumor diseases take on average several months, and congenital diseases take several years on average. Considering the patient’s age, neck lumps in patients under 20 years of age are mostly congenital diseases or inflammatory diseases; Patients over 40 years old need to pay attention to the occurrence of metastatic cancer; And young women aged 20 to 40 are more common. Tuberculous lymphadenitis.
Local symptoms of inflammatory diseases typically include redness, swelling, warmth, and pain; Benign tumors are mostly isolated lesions with smooth surfaces, clearly demarcated from surrounding tissues, and mobile when touched; Malignant tumors are more common as multiple lesions. Sexually, the dividing line with the surrounding tissues is not obvious, and the wound heals when touched.
The location of the tumor in the neck is also helpful in clinical differential diagnosis, especially in the case of metastatic lymph nodes in the neck from different areas, which usually come from a specific primary site of the head and neck, such as: this located in the supraclavicular triangle. In addition to the possibility that the primary source of the tumor is head and neck cancer, the digestive tract, abdominal organs, and lungs should also be carefully examined to locate the potential primary site.
Since neck tumors can metastasize to the head and neck, the organs located in the head and neck, such as the nasal cavity, nasopharynx, oral cavity, oropharynx, larynx, and hypopharynx, should be examined at the same time. The doctor will use Reflex. Use microscope, soft fiberscope, rigid endoscope, etc. to check whether there are any abnormalities in the mucosa of these parts. If necessary, a biopsy may also be done at the same time.
White blood cells in routine blood tests are helpful in differential diagnosis. In addition, since nasopharyngeal cancer is a common malignant tumor in China and is closely related to Epstein-Barr virus, it is also very important to draw blood for testing Epstein-Barr virus serology (EBV VCA IgA, EA IgA).
For neck masses, ultrasound examination of the soft tissues of the neck can help make effective differential diagnosis, and even cytologic examination can be performed through ultrasound-guided puncture and aspiration. For those In those whose medical history and physical examination suggest that a neck tumor may be a head and neck metastatic cancer, but a primary tumor cannot be found, use of computed tomography or magnetic resonance imaging to help find the potential primary tumor. can be done.
After the above detailed medical history, physical examination, endoscopy, blood test and imaging test, various diagnostic results will be obtained and corresponding treatment methods will be obtained.
Swollen neck lumps: Treated mainly with medications.
Benign neck lumps: Most treatments involve surgical removal.
Thyroid disease: Depending on the size of the nodule, ultrasound imaging, and cytological diagnosis, oral medications may be given, and radiofrequency ablation or thyroidectomy may be arranged.
Malignant tumors: Related treatments are given according to their original site and stage, mostly surgical resection, chemotherapy and radiotherapy. In particular, if no primary lesion is found but EBV serology testing is abnormal, it is recommended to first perform biopsy diagnosis in the nasopharynx to eliminate the possibility of nasopharyngeal cancer. The main reason is that nasopharyngeal cancer is very sensitive to radiotherapy. , so the metastatic mass of nasopharyngeal cancer in the neck does not require surgical treatment.
Doctors say that the diagnosis of neck tumors is very diverse, and the above step-by-step medical history and examination should be followed to help establish the diagnosis. Because this is a common symptom of malignant tumors of the head and neck, it is advisable to seek treatment from an otolaryngologist as soon as possible if an undiagnosed neck tumor occurs. A detailed examination will be done depending on the location of the tumor and the patient’s symptoms. If it is a fatal disease, early detection can be done and the most appropriate treatment can be given as soon as possible. This will also reduce difficulties in future treatments and improve cure rates.
Source: Health Medical Network
Health(TagstoTranslate)Tumor
