a Neck Lump: When to Seek ENT Evaluation

Q: a Neck Lump: When to Seek ENT Evaluation

Hello： Generally, if there are no significant changes in size, it is often a benign condition. <br>If you are concerned or uncertain, you may visit a hospital for examination or further confirmation. <br>Wishing you peace and health. <br>Sincerely, Dr. <br>Cheng Jue-Yi, Director

I have a lump on the left side of my Adam's apple?

Last month, I came across an article online about neck lumps and decided to examine my own neck.
I found a lump measuring about 2.2 cm located just below my Adam's apple on the left side.
I have the impression that it has been there for several years, as I thought it was just part of my Adam's apple and didn't pay much attention to it.
It is not painful or bothersome, and I am unsure if it is soft or hard.
When I touch it, it feels somewhat soft with a bit of firmness, and it is movable.
I have consulted three ENT specialists: one said to not worry about it for now, another diagnosed it as a lymph node and suggested I have it checked every two weeks, and the third said that nothing could be determined at the ENT clinic and recommended going to a larger hospital for further examination (I felt this doctor was somewhat casual in their approach).

1.
It has been about a month since I first noticed it, and it appears to be the same size, with the same consistency and mobility.
Could this be a benign tumor?
2.
I had undergone a colonoscopy, gastroscopy, and endoscopy in 2017, and a thyroid ultrasound at the end of 2016, all of which were normal.
Can we rule out some concerns based on this history?
3.
Should I go for an examination at a larger hospital? Thank you for your response, doctor.

Luo Kairen, 20~29 year old female. Ask Date: 2018/01/06

Dr. Zheng Jueyi reply Otolaryngology

Hello: Generally, if there are no significant changes in size, it is often a benign condition.
If you are concerned or uncertain, you may visit a hospital for examination or further confirmation.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/01/06

More Info

When it comes to evaluating a neck lump, particularly one that has been present for an extended period, it is essential to approach the situation with caution and thoroughness. Based on your description, you have a 2.2 cm lump located just below your Adam's apple, which has been stable in size and characteristics for several years. You have consulted three ENT specialists, each providing different insights into the nature of the lump, which adds to the complexity of your situation.

1. Characteristics of the Lump: The fact that the lump is soft, somewhat firm, mobile, and does not cause pain or discomfort is generally reassuring. These characteristics often suggest that the lump could be benign, such as a lipoma (a fatty tumor), a cyst, or a reactive lymph node. However, the mobility and consistency can vary significantly between benign and malignant lesions, so it is crucial to consider further evaluation.

2. Duration and Stability: The stability of the lump over several years is a positive sign, as many malignant tumors tend to grow more rapidly and change in characteristics. However, the fact that it has not changed in size does not definitively rule out malignancy, especially if it is a slow-growing cancer.
3. Previous Evaluations: Given that you have had normal results from previous examinations, including endoscopies and imaging studies, this is encouraging. However, the absence of findings does not eliminate the possibility of a new or developing condition.
4. When to Seek Further Evaluation: It is advisable to seek further evaluation if:
- The lump changes in size, shape, or consistency.

- New symptoms develop, such as pain, difficulty swallowing, or changes in voice.

- There is any concern from your healthcare providers regarding the nature of the lump.

In your case, since you have already seen multiple specialists and the lump has remained unchanged, it may be prudent to consider a more comprehensive evaluation at a larger medical center. This could include imaging studies such as an ultrasound or CT scan, which can provide more detailed information about the lump's characteristics and its relationship to surrounding structures. Additionally, if there is any suspicion of malignancy, a biopsy may be warranted to obtain a definitive diagnosis.

5. Conclusion: While the characteristics of the lump you describe are suggestive of a benign process, it is essential to remain vigilant. Given your history and the differing opinions from specialists, pursuing further evaluation at a larger hospital or a specialized center may provide you with peace of mind and a clearer understanding of your condition.
In summary, while the lump may likely be benign based on its characteristics and stability, further evaluation is warranted to rule out any potential issues. It is always better to err on the side of caution when it comes to changes in your health, especially when it involves a lump in the neck area.

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