Neck Lumps: When to Seek Medical Attention

Neck issues

Hello, doctor.
About a month ago (in October this year), I discovered a protrusion above the right carotid artery in my neck, approximately 1 cm in size.
I can see the blood vessel in the mirror, and the lump is movable from side to side.
It feels warm and pulsates when touched.
I need to tilt my head back to notice the protruding area.
There is also a small lump in the left deep neck area that is not easily visible with the blood vessels, feels warm, and is also movable from side to side.
I need to tilt my head back to notice this small lump.
In July and August, I had a case of bilateral tonsillitis that became purulent, and I recovered after taking antibiotics for a month.
I am unsure if this is a residual effect from that time.
Currently, I occasionally experience irregular body warmth but have no other discomfort.
The lump has neither increased nor decreased in size.
Should I continue to monitor it, or should I seek medical attention?

Tai De, 20~29 year old female. Ask Date: 2019/11/11

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your description, it is most likely that you are experiencing pharyngotonsillitis accompanied by cervical lymphadenopathy, which is often treated with medication, and antibiotics may be used if necessary.
There are numerous possibilities for cervical masses, including benign tumors, congenital cysts, lymphoid hyperplasia, and even malignancies.
If the cervical swelling persists or continues to progress, it is advisable to consult an otolaryngologist.
Wishing you peace and good health.

Sincerely,
Dr.
Chi Chao-Yun
Director, Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare

Reply Date: 2019/11/11

More Info

When it comes to neck lumps, particularly those that have recently appeared, it is essential to approach the situation with caution and awareness of the potential underlying causes. Based on your description, you have noticed two lumps in your neck, one on the right side above the artery and another in the left deep neck area. Both lumps are movable, warm to the touch, and have been present since your recovery from a previous infection involving your tonsils. Given these details, let’s break down the situation and discuss when it is appropriate to seek medical attention.

Firstly, the characteristics of the lumps you described—movable, warm, and pulsating—suggest that they could be related to vascular structures, such as arteries or veins, or possibly lymph nodes. The fact that they are warm could indicate increased blood flow or inflammation, which might be a residual effect of your previous infection. Lymph nodes can become enlarged in response to infections, and they may remain palpable even after the infection has resolved. However, it is crucial to monitor any changes in size, shape, or associated symptoms.

In general, there are specific signs and symptoms that warrant immediate medical evaluation:
1. Rapid Growth: If the lumps increase in size significantly over a short period, this could indicate a more serious condition that requires further investigation.

2. Persistent Symptoms: If you experience persistent fever, night sweats, unexplained weight loss, or fatigue, these could be signs of an underlying infection or malignancy.

3. Pain or Discomfort: While some lumps may be painless, any new pain or discomfort associated with the lumps should be evaluated.

4. Changes in Texture or Mobility: If the lumps become fixed (not movable) or change in texture (hardening), this could be concerning.

5. Neurological Symptoms: If you experience any neurological symptoms such as weakness, numbness, or difficulty swallowing, seek immediate medical attention.

Given that you have a history of tonsillitis and have recently experienced irregular body temperatures, it would be prudent to consult a healthcare professional. They may perform a physical examination and possibly order imaging studies, such as an ultrasound or CT scan, to better understand the nature of the lumps. Blood tests may also be helpful to check for signs of infection or inflammation.

In your case, since the lumps have not changed in size and you have no significant discomfort, you might consider a watchful waiting approach for a short period. However, if you notice any of the concerning signs mentioned above, do not hesitate to seek medical attention. It is always better to err on the side of caution when it comes to unexplained lumps, especially in the neck area, where many vital structures are located.

In conclusion, while it is possible that the lumps are benign and related to your previous infection, it is essential to remain vigilant. Regular self-examinations and awareness of any changes in your body will help you make informed decisions about your health. If in doubt, consulting a healthcare provider is always a wise choice. They can provide personalized advice based on a thorough evaluation of your symptoms and medical history.

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