Neck Masses: A Patient's Journey Through Diagnosis and Treatment

Neck mass

Hello doctor, about 13 years ago, when I was around 16 or 17 years old, I discovered a lump under my right ear on my neck.
At first, it was a small bump that felt like a mosquito bite, which was itchy and painful.
After about two weeks, it developed into a larger lump, though I can't recall its exact size.
I went to the ENT department at National Taiwan University Hospital for a fine needle aspiration biopsy.
A week later, the doctor informed me that there were cancer cells present and suspected nasopharyngeal carcinoma.
An endoscopy was performed, where the doctor examined both nostrils and found no abnormalities.
I was then referred to an oncologist, who noted that the lump was very superficial and did not resemble a typical tumor, suggesting that it could simply be excised.
Two days later, I underwent surgery to remove it.
The doctor later showed me the excised tissue, which was yellow and resembled a small ball.
I was scheduled for a follow-up appointment the next day, during which I was only instructed on how to clean the wound and change the dressing.
After that, I did not return for any follow-up visits.
Now, after more than a decade, I feel a bit uneasy and wonder if I should go back to review the report regarding that lump.

Yuan Yuan, 30~39 year old female. Ask Date: 2016/03/20

Dr. Chen Sirong reply Oncology

Yuan Yuan / 30 years old / Female
1.
The tissue that was removed 13 years ago should not be a concern now.

2.
It is advisable to return for follow-up appointments; regular monitoring is beneficial, ideally every 1-2 years.

3.
You can visit an ENT specialist when you have a cold for a check-up as well.

Thank you for your letter.

Taoyuan Hospital
Dr.
Chen Si-Rong

Reply Date: 2016/03/20

More Info

Understanding neck masses and their implications can be a complex journey, especially when it involves a potential malignancy like nasopharyngeal carcinoma. Your experience highlights several important aspects of diagnosis and treatment that are crucial for patients facing similar situations.

First, it’s essential to recognize that any new or changing mass in the neck, especially in the context of symptoms like itching, pain, or rapid growth, warrants thorough evaluation. In your case, the initial presentation of a small, itchy bump that progressed to a larger mass is concerning and should be taken seriously. The fact that a fine needle aspiration (FNA) revealed cancer cells is a significant finding that necessitates further investigation.

The subsequent steps you underwent, including an endoscopic examination, were appropriate. Endoscopy allows for direct visualization of the nasal passages and nasopharynx, which is critical in ruling out primary tumors in those areas, especially when there is a suspicion of nasopharyngeal carcinoma. The absence of abnormalities during this procedure is reassuring, but it does not entirely eliminate the possibility of malignancy, particularly if the mass is superficial and not directly visible during the examination.

The decision made by the oncologist to surgically excise the mass, given its superficial nature, was a reasonable approach. Surgical removal of superficial masses can often provide both diagnostic and therapeutic benefits. The yellow, ball-like appearance of the excised tissue you described could suggest a variety of conditions, including benign lesions such as cysts or lipomas, but the definitive diagnosis would depend on the histopathological examination of the tissue.

After surgery, it’s common for patients to feel uncertain about follow-up care, especially when they have been informed of a previous malignancy. In your case, the lack of follow-up appointments or further discussions about the pathology report may leave you feeling uneasy. It is crucial to have clarity on the nature of the excised mass and whether any further treatment or monitoring is necessary.

Given that over a decade has passed since your surgery, it would be prudent to consult with a healthcare provider, preferably an ENT specialist or an oncologist, to discuss your past diagnosis and the excised mass. They may recommend imaging studies, such as an ultrasound or MRI, to assess the area where the mass was located and to ensure there are no new developments. Additionally, reviewing the pathology report from your surgery could provide valuable information regarding the nature of the mass and any potential implications for your health moving forward.

In summary, your journey underscores the importance of thorough evaluation and follow-up in the management of neck masses. If you have lingering concerns or symptoms, seeking a consultation is advisable. Early detection and intervention are key in managing any potential recurrence or new issues, especially in the context of a previous cancer diagnosis. Your health and peace of mind are paramount, and addressing these concerns with a medical professional can help ensure that you receive the appropriate care and reassurance.

Similar Q&A

Understanding Neck Masses: When to Seek Medical Evaluation

Hello Doctor, I have noticed a lump on the left side of my cervical spine over the past couple of days. Recently, an ENT specialist examined my throat and found no issues. The lump is not very prominent; it feels slightly raised, seems to be immobile, and is not very painful. I a...

Dr. Zeng Guosen reply Internal Medicine
Dear netizens, lumps in the head and neck region are generally first evaluated by an otolaryngologist. If the nature of the lump cannot be determined, it is recommended to consult a plastic surgeon for further evaluation. Most lumps located at the back of the neck are benign, so ...

Understanding Neck Tumors: Diagnosis, Treatment, and Recovery Insights

A couple of months ago, I developed a small bump at the junction of my neck and chin that resembled an acne lesion. Initially, I didn't think much of it, but it later grew to about two centimeters and felt like a soft mass. Two weeks ago, it became red and swollen. I first c...

Dr. Xu Jiazhen reply Otolaryngology
Hello: In response to your question, based on the description, it is possible that the cyst is caused by inflammation or blockage of the thyroglossal duct. When addressing the concerns of netizens, this diagnosis will be taken as a premise. 1. The thyroglossal duct is a remnant...

Understanding Benign Tumors: Evaluating Surgical Options and Symptoms

Hello Doctor, in early May, after fainting, a subsequent CT scan revealed a tumor near my neck close to the tonsils. I was referred to a larger hospital for further examination, and later an MRI showed that the images appeared as multiple small nodules rather than one larger mass...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if the results of a biopsy are benign, whether surgery is necessary primarily depends on whether the clinical symptoms are bothersome or affect normal daily life, or on the rate of tumor growth during regular follow-ups. Of course, the risks associated with surgery must al...

Understanding Neck Pain and Lumps: When to Consider Surgery

Hello, Doctor. On June 1st, I suddenly experienced severe pain in my neck and felt a lump that was oval-shaped and soft, resembling a gummy candy. I visited a clinic where the doctor prescribed antibiotics for a week, but after finishing the medication, the lump did not decrease ...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, based on your description, it is most likely that the cervical lymphadenopathy is accompanied by inflammation, which is often treated with medication, including antibiotics if necessary. However, if the swelling in the neck continues to progress and leads to a deep neck in...