Neck surgery
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Neck surgery
Common symptoms of benign neck masses
- Visible lump or swelling in the neck;
- Discomfort or pain in the neck area;
- Difficulty moving the head or shoulder;
- Changes in neck contour;
- Pressure sensation in the throat;
- Difficulty swallowing (in some cases);
- Hoarseness (rarely).
The neck: an overview
The neck anchors the head while allowing multidirectional movement.. It represents one of the most complex anatomical regions, intimately linked with the head anatomy.
Anatomically, the neck contains the cervical spine, the trachea, the larynx, the esophagus, around 300 lymph nodes, muscles, nerves, connective tissue, and skin. For this reason, the pathology of the neck is very wide-ranging.
The diagnostic workup is heavily supported by imaging tests. Many neck lumps need a fine needle biopsy before planning a treatment strategy.
This article focuses on representative cases of benign neck masses.
Lipoma
The first case belongs to a woman with a slow-growing mass on the left side of her neck, distorting its contour. She was also complaining of a slight limitation in moving up her left shoulder.
It was a lipoma, a benign tumor of fat cells. In this particular case, it was compressing the accessory nerve on its way to supply the trapezius muscle, limiting shoulder movement. After removal, the neck regained its normal curvature, preserving the nerve and its function.
Another case of lipoma was located at the anterior part of the neck. Imaging and cytology help to differentiate it from thyroglossal cyst.
- Before surgery
- 4 months post-op
- 18 months post-op
Submandibular gland tumor
This mass is a submandibular gland tumor. When removing this tumor, it is important to take into account not only the facial nerve but also the lingual nerve.
Please visit the Salivary glands page.
- Before surgery
- 7 weeks post-op
Paraganglioma
This woman had discomfort on the right side of her neck, particularly when rotating her head. Imaging exams revealed a paraganglioma (a neuroendocrine tumor), located at the carotid bifurcation. It was removed, and nowadays she has no symptoms. However, genetic tests showed a hereditary mutation, which means there is a risk of having other paragangliomas. Therefore, she’s under lifelong follow-up.
- Before surgery
- 1 year post-op
Branchial cleft cyst
Branchial cleft cysts are embryonic (congenital) abnormalities, meaning it’s a condition present at birth. Despite being congenital, these cysts often become symptomatic only in late childhood or early adulthood.
- Before surgery
- 2 weeks post-op
- 1 year post-op
This young woman had nothing but slight discomfort over the past months. Despite no evident mass at inspection, the clinical examination, CT scan, and cytology pointed toward what after surgery was confirmed to be a branchial cleft cyst. The mass was removed from a delicate position with important structures to preserve:
- The hypoglossal nerve, that supplies the tongue muscles;
- The accessory nerve, for trapezius and sternocleidomastoid muscle;
- Major neck vessels.
- Before surgery
- Clinical examination
- 8 months post-op
Frequently asked questions
Are all neck lumps cancerous?
No, many neck lumps are benign. Common benign masses include lipomas, branchial cleft cysts, and paragangliomas.
When should I see a doctor about a neck lump?
Consult us if you notice any persistent lump, especially if it’s growing or causing discomfort.
What tests are used to diagnose neck masses?
Diagnosis often involves imaging tests like CT scans and sometimes fine needle biopsies.
Is surgery always necessary for benign neck masses?
Not always, but surgery is often recommended for large, growing, or symptomatic masses.
Are there risks associated with neck surgery?
While generally safe, risks can include damage to nearby nerves or blood vessels. Your surgeon will discuss specific risks based on the location and type of mass.
Take care of your neck!
Benign neck masses are common and varied, including lipomas, branchial cleft cysts, and paragangliomas. While often not life-threatening, these masses can cause discomfort and affect appearance. Proper diagnosis through imaging and sometimes biopsy is crucial. Surgical removal is often the treatment of choice, requiring careful consideration of surrounding vital structures.
If you’ve noticed an unusual lump or mass in your neck, don’t hesitate to seek medical advice. Early evaluation can lead to quicker diagnosis and more effective treatment. Schedule a consultation with a neck specialist today to discuss your symptoms and explore your options for diagnosis and treatment.”
