Hard Lumps on Both Sides of the Neck: ENT Insights - Otolaryngology

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Hard lumps on both sides of the neck?


I accidentally discovered hard lumps on the inner side of the facial bones, specifically where the face connects to the neck.
These lumps are not visible to the naked eye and can only be felt when pressed with my fingers.
Both sides have similar findings, approximately symmetrical.
On the left side, there are two lumps: one small (slightly larger than a grain of rice) and one larger (oval-shaped, about 1.5 cm, slightly less than a finger joint).
On the right side, there is one small lump (also slightly larger than a grain of rice) that is not painful when pressed, somewhat firm but not as hard as a stone, and it can be moved.
I can push it out from beneath the facial bone when I apply pressure.
I kindly ask for your clarification, thank you.

Wu, 20~29 year old female. Ask Date: 2019/03/27

Dr. Zheng Jueyi reply Otolaryngology


Hello: Commonly, lymph nodes in the neck may be present.
If there are no obvious discomforts and their size remains unchanged, you can observe them for now.
However, if they continue to enlarge or become painful, you should seek medical evaluation.
Wishing you safety and health.
Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/03/27

More Info


The presence of hard lumps on both sides of the neck, particularly in the area where the face connects to the neck, can be concerning and warrants further evaluation. Based on your description, these lumps are not visible but can be felt upon palpation, which suggests they may be located in deeper tissues, possibly involving lymph nodes, salivary glands, or other soft tissue structures.


Possible Causes of Hard Lumps in the Neck
1. Lymphadenopathy: The most common cause of hard lumps in the neck is swollen lymph nodes. Lymph nodes can become enlarged due to infections (viral or bacterial), inflammatory conditions, or malignancies. Given that you mentioned the lumps are not painful, this could suggest a benign process, but it is essential to consider the possibility of underlying pathology.

2. Salivary Gland Issues: The submandibular and parotid glands can also present as lumps in the neck area. Conditions such as sialadenitis (inflammation of the salivary glands) or salivary stones can lead to swelling. If these lumps are related to the salivary glands, you might notice symptoms like dry mouth or difficulty swallowing.

3. Cysts: Epidermoid cysts or branchial cleft cysts can also present as lumps in the neck. These are typically benign and may feel firm but are usually movable and not painful.

4. Fibromas or Lipomas: These are benign tumors that can develop in the soft tissues of the neck. They are usually soft to firm and can be mobile under the skin.

5. Thyroid Nodules: If the lumps are located more centrally in the neck, they could be related to the thyroid gland. Thyroid nodules are common and often benign, but they require evaluation to rule out malignancy.


Recommended Next Steps
1. Consult an ENT Specialist: Given the location and nature of the lumps, it would be prudent to consult an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination, including a physical assessment and possibly imaging studies like an ultrasound or CT scan to better characterize the lumps.

2. Imaging Studies: An ultrasound of the neck can help differentiate between solid masses and cystic lesions and provide information about the size and characteristics of the lumps. If there is any suspicion of malignancy, a CT scan may be warranted.

3. Biopsy: If the lumps persist or change in size or characteristics, a biopsy may be necessary to obtain a definitive diagnosis. This can be done through fine-needle aspiration or excisional biopsy, depending on the situation.

4. Monitoring: If the lumps are determined to be benign and not causing any symptoms, your doctor may recommend a watchful waiting approach, with regular follow-ups to monitor for any changes.


Conclusion
While the presence of hard lumps in the neck can be alarming, many causes are benign. However, it is crucial to seek medical evaluation to rule out any serious conditions. Early diagnosis and management are key to addressing any underlying issues effectively. Please make an appointment with an ENT specialist as soon as possible to discuss your symptoms and get the appropriate care.

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