Neck Lumps: When to Seek Medical Advice

There is a hard lump in the neck?

I noticed a lump in my neck today during the New Year celebrations.
It's located on the side and back of my neck, and I measured it to be about 1.5 centimeters in size.
It moves around when I touch it.
There is also another smaller lump, about the size of a grain of rice, located beneath the 1.5 cm lump.
Both are painless and movable.
I do not smoke or drink alcohol, and I am 18, almost 19 years old.
I have seen a family medicine doctor at the hospital, who assessed that it is likely a normal lymph node and advised me to monitor it for any changes in size.
However, it has not changed in size over the past six months.
Should I seek further medical evaluation? Is there a significant chance that it could be a tumor? I'm quite worried.

Jie, 10~19 year old female. Ask Date: 2015/06/25

Dr. Lai Yicheng reply Oncology

Hello,
Neck masses can be broadly categorized into three main types: congenital, inflammatory, and neoplastic.

1.
Congenital masses: These are more common in children but can also appear in adults.
They include branchial cleft cysts (which account for approximately 20% of neck masses in children), thyroglossal duct cysts, dermoid cysts, and vascular anomalies (such as hemangiomas and vascular malformations).

2.
Inflammatory masses: These are more prevalent in young adults and typically have an infectious source, which can be viral, bacterial, or fungal in nature.

3.
Neoplastic masses: These can be classified as benign or malignant, with malignant tumors further divided into primary and metastatic tumors.

There are numerous causes for the formation of hard masses in the neck, and it is advisable to consult an otolaryngologist for diagnosis and treatment.

Sincerely,
Dr.
Lai, Department of Radiation Oncology, Changhua Hospital

Reply Date: 2015/06/25

More Info

When it comes to neck lumps, particularly in young individuals like yourself, it's important to understand the potential causes and when to seek medical advice. Based on your description, you have noticed a movable lump about 1.5 cm in size on the side of your neck, along with a smaller lump beneath it. The fact that these lumps are movable and painless is generally a reassuring sign, as many serious conditions tend to present with fixed, hard, and painful masses.

Lumps in the neck can arise from various causes, with the most common being lymphadenopathy, which is an enlargement of the lymph nodes. This can occur due to infections (viral or bacterial), inflammatory conditions, or, less commonly, malignancies. Given that you are 18 years old, the likelihood of these lumps being cancerous is relatively low, especially since you have been monitored for six months without any change in size.

Your healthcare provider's recommendation to observe the lumps is a common approach, especially when they are small, movable, and painless. However, there are certain situations where further evaluation is warranted:
1. Size Increase: If the lumps begin to grow in size, this could indicate a need for further investigation.

2. Duration: While you have been monitoring these lumps for six months, if they persist for longer than a year without change, it may be advisable to seek further evaluation.

3. Associated Symptoms: If you develop any new symptoms such as fever, night sweats, unexplained weight loss, or difficulty swallowing, these could be red flags that warrant immediate medical attention.

4. Change in Characteristics: If the lumps become painful, fixed, or change in texture, this could also indicate a need for further assessment.

5. Family History: If there is a family history of cancers or other significant medical conditions, this may also influence the decision to seek further evaluation.

In your case, since the lumps have remained stable and you have no other concerning symptoms, it may not be necessary to seek immediate medical attention. However, it is always better to err on the side of caution. If you have persistent anxiety about the lumps or if there are any changes in their characteristics, it would be wise to consult with a healthcare professional for peace of mind.

In conclusion, while the likelihood of these lumps being malignant is low given your age and the characteristics you've described, ongoing observation is key. If you notice any changes or if your anxiety about the lumps increases, don't hesitate to seek further medical advice. Regular check-ups with your healthcare provider can help ensure that any potential issues are caught early, should they arise.

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