Lumps in the Neck: When to Seek Medical Advice

Q: Lumps in the Neck: When to Seek Medical Advice

Dear Sir/Madam： 1. Theoretically, cancer is less likely to fluctuate significantly in size. 2. It is advisable to have an outpatient consultation. Dr. Yeh Da-Wei, Director of the Department of Otolaryngology, Hsinchu Hospital.

There is a small hard lump on the left side of the neck?

Hello, Director Yeh.
About three years ago, I noticed a lymph node on both sides of my neck, approximately 1 cm in size, which fluctuated in size.
At that time, I was under a lot of work stress and also experienced tinnitus.
I went to the hospital for an examination, and they said there was no issue.
I also had a nasopharyngoscopy, which showed no abnormalities.
Now that I think about it, I wonder if it was to check for nasopharyngeal cancer.
Shortly after that, I developed a painful bump on the left side of my neck, roughly aligned with my hairline, which resembled an acne lesion but was much larger, about 1.5 cm.
Initially, it was larger, but after some time, the bump subsided, leaving a hard lump about 1 cm in size, which became painless.
When I returned for a follow-up, I informed the doctor, who advised me not to worry.
It seemed to have disappeared afterward.
Recently, a similar situation has occurred in the same area on the left side of my neck.
It started as an acne lesion, and a few days later, the pain disappeared, and now it has turned into a small hard lump, approximately 1 cm, which has not changed for over a week.
I am still quite worried, especially since it has been a long time since my last examination.
Should I consider getting checked again? Is it true that a small hard lump is not a cause for concern, or would it be better to schedule an appointment for a doctor to examine it? I have friends of the same age who have been diagnosed with nasopharyngeal cancer, and seeing that even with advancements in medicine, people still face serious health issues and the significant financial and emotional burdens of treatment is quite concerning.

Kunrao, 30~39 year old female. Ask Date: 2009/06/02

Dr. Ye Dawei reply Otolaryngology

Dear Sir/Madam:
1.
Theoretically, cancer is less likely to fluctuate significantly in size.

2.
It is advisable to have an outpatient consultation.

Dr.
Yeh Da-Wei, Director of the Department of Otolaryngology, Hsinchu Hospital.

Reply Date: 2009/06/02

More Info

When it comes to lumps in the neck, particularly lymph nodes, it’s essential to approach the situation with caution and awareness. Your experience of having noticed lumps on both sides of your neck, which have fluctuated in size, is not uncommon. Lymph nodes can swell in response to infections, inflammation, or other medical conditions, and they can also return to normal size once the underlying issue resolves. However, persistent or recurrent lumps warrant further investigation.

Given your history of experiencing these lumps, along with the recent appearance of a painful bump that later turned into a hard mass, it is advisable to seek medical advice again. While your previous examinations, including a nasopharyngoscopy, did not reveal any abnormalities, the recurrence of similar symptoms suggests that a follow-up is prudent. The fact that you have a family history of nasopharyngeal cancer in your peer group adds to the importance of being vigilant about any changes in your health.

Here are some key points to consider regarding when to seek medical advice for lumps in the neck:
1. Duration and Changes: If a lump persists for more than two weeks, especially if it changes in size, shape, or consistency, it is time to consult a healthcare professional. In your case, the lump has been present for over a week without significant change, which is a good reason to seek further evaluation.

2. Associated Symptoms: Pay attention to any accompanying symptoms such as fever, night sweats, unexplained weight loss, or persistent pain. These could indicate a more serious underlying condition that requires immediate attention.

3. Physical Characteristics: Lumps that are hard, fixed to the surrounding tissue, or larger than 1 cm should be evaluated. The lump you described, which is about 1 cm and has changed from painful to hard, fits this criterion.

4. Medical History: Your previous experiences with lymph nodes and the stress you mentioned could contribute to your current concerns. Stress can sometimes exacerbate physical symptoms, but it’s essential to rule out any serious conditions.

5. Professional Evaluation: A healthcare provider may recommend imaging studies, such as an ultrasound or CT scan, to assess the lump further. They may also perform a biopsy if there is any suspicion of malignancy.

In conclusion, while many lumps in the neck are benign and related to infections or other non-cancerous conditions, your history and the current situation suggest that a follow-up appointment with a healthcare professional is warranted. It’s better to err on the side of caution, especially given the potential seriousness of conditions like nasopharyngeal cancer. Your health and peace of mind are paramount, and getting a thorough evaluation can help alleviate your concerns and ensure that any necessary treatment is initiated promptly.

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