Risk factors vary depending on the cancer site and include: Tobacco use (smoking or chewing) Alcohol consumption Human papillomavirus (HPV), particularly for oropharyngeal cancer Sun exposure (lip cancer)

Head and Neck Conditions

Q: Common Causes of Neck Lumps

Enlarged Lymph Nodes The most common cause of neck lumps. Lymph nodes often enlarge in response to infection or inflammation and usually resolve over time. Infections Viral or bacterial infections of the throat, tonsils, teeth, skin, or salivary glands can lead to tender neck lumps. Thyroid Conditions Thyroid nodules or goitre can present as a lump in the lower front of the neck. Salivary Gland Disorders Blockage, infection, or tumours of the salivary glands may cause lumps under the jaw or near the ear. Congenital Lumps Some neck lumps are present from birth or childhood, such as branchial cleft cysts or thyroglossal duct cysts. Tumours Both benign and malignant tumours can present as neck lumps. In adults, a persistent, painless neck lump may represent head and neck cancer until proven otherwise. Red flag symptoms Features that may require urgent assessment include: A lump persisting for more than 2 weeks Rapidly increasing size A firm or hard lump Painless swelling Associated voice change, difficulty swallowing, or breathing problems Unexplained weight loss or night sweats History of smoking or alcohol use

Q: Assessment and Diagnosis

Clinical Examination Assessment of the neck, mouth, throat, larynx, and salivary glands, along with a full head and neck examination. Endoscopic Examination Flexible nasendoscopy may be performed in the clinic to assess the upper aerodigestive tract. Imaging Ultrasound, CT, or MRI may be used to define the nature and extent of the lump. Fine Needle Aspiration (FNA) Biopsy A minimally invasive biopsy often performed under ultrasound guidance to obtain cells for diagnosis.

Q: Management and Treatment

Management depends on the underlying cause: Observation or medical treatment for reactive lymph nodes or infections Surgical removal of benign cysts or tumours Surgical and oncological management for malignant conditions Neck Lumps in Children In children, neck lumps are most commonly related to infection or congenital conditions. However, persistent or enlarging lumps still require specialist assessment to ensure appropriate management. When to See an ENT Surgeon Referral to an ENT surgeon is recommended if: A neck lump persists beyond 2 weeks The lump is enlarging, firm, or painless There are associated symptoms affecting speech, swallowing, or breathing Imaging or biopsy is required There is concern about cancer

Expert evaluation and treatment of neck lumps and head and neck cancer

A neck lump is a common reason for referral to an ENT surgeon. While many neck lumps are benign and related to infection or inflammation, some require further investigation to exclude more serious conditions, including cancer.

Neck lumps

What Is a Neck Lump?

A neck lump is any swelling or mass in the neck. Neck lumps may arise from lymph nodes, salivary glands, thyroid gland, skin, or other soft tissues. They can occur in both children and adults, with causes varying depending on age and clinical features.

Common Causes of Neck Lumps

Enlarged Lymph Nodes
The most common cause of neck lumps. Lymph nodes often enlarge in response to infection or inflammation and usually resolve over time.

Infections
Viral or bacterial infections of the throat, tonsils, teeth, skin, or salivary glands can lead to tender neck lumps.

Thyroid Conditions
Thyroid nodules or goitre can present as a lump in the lower front of the neck.

Salivary Gland Disorders
Blockage, infection, or tumours of the salivary glands may cause lumps under the jaw or near the ear.

Congenital Lumps
Some neck lumps are present from birth or childhood, such as branchial cleft cysts or thyroglossal duct cysts.

Tumours
Both benign and malignant tumours can present as neck lumps. In adults, a persistent, painless neck lump may represent head and neck cancer until proven otherwise.

Red flag symptoms
Features that may require urgent assessment include:

A lump persisting for more than 2 weeks
Rapidly increasing size
A firm or hard lump
Painless swelling
Associated voice change, difficulty swallowing, or breathing problems
Unexplained weight loss or night sweats
History of smoking or alcohol use

Assessment and Diagnosis

Clinical Examination
Assessment of the neck, mouth, throat, larynx, and salivary glands, along with a full head and neck examination.

Endoscopic Examination
Flexible nasendoscopy may be performed in the clinic to assess the upper aerodigestive tract.

Imaging
Ultrasound, CT, or MRI may be used to define the nature and extent of the lump.

Fine Needle Aspiration (FNA) Biopsy
A minimally invasive biopsy often performed under ultrasound guidance to obtain cells for diagnosis.

Management and Treatment

Management depends on the underlying cause:

Neck Lumps in Children
In children, neck lumps are most commonly related to infection or congenital conditions. However, persistent or enlarging lumps still require specialist assessment to ensure appropriate management.

When to See an ENT Surgeon
Referral to an ENT surgeon is recommended if:

A neck lump persists beyond 2 weeks
The lump is enlarging, firm, or painless
There are associated symptoms affecting speech, swallowing, or breathing
Imaging or biopsy is required
There is concern about cancer

Head and Neck Cancer

Head and neck cancer refers to a group of cancers that arise in the mouth, throat, voice box, nose, sinuses, salivary glands, and lymph nodes of the neck. Early diagnosis and specialist management are critical, as outcomes are significantly improved when treatment begins promptly.

What is Head and Neck Cancer?

Head and neck cancers most commonly arise from the lining of the upper aerodigestive tract and are typically squamous cell carcinomas. These cancers can affect essential functions such as speech, swallowing and breathing.

Common Sites of Head and Neck Cancer

Oral cavity (tongue, lips, floor of mouth, gums)
Oropharynx (tonsils, base of tongue)
Larynx (voice box)
Hypopharynx
Nasal cavity and sinuses
Salivary glands
Lymph nodes of the neck

Risk Factors

Risk factors vary depending on the cancer site and include:

Symptoms and Warning Signs

Symptoms depend on the location of the cancer and may include:

A persistent lump in the neck
An ulcer in the mouth that does not heal
Persistent sore throat
Difficulty or pain with swallowing
Hoarseness or voice change lasting more than 2 weeks
Unexplained weight loss
Ear pain
Nasal blockage or bleeding (for nasal and sinus cancers)

Any persistent or unexplained symptom should be assessed promptly.

Assessment and Diagnosis

Clinical Examination
Comprehensive head and neck examination, including inspection of the mouth, throat, larynx, and neck.

Endoscopic Assessment
Flexible nasendoscopy is commonly performed to visualise the throat and voice box.

Imaging
CT, MRI, or PET scans are used to assess the size of the tumour and spread to surrounding tissues or lymph nodes.

Biopsy
Tissue sampling is required to confirm the diagnosis and determine tumour type.

Treatment and Management

Treatment is individualised and depends on tumour site, stage, pathology, and patient factors. A multidisciplinary team of specialist head and neck oncologists work together to recommend a personalised treatment plan for each patient.

Surgery
Surgical removal of the tumour and involved lymph nodes may be recommended.

Radiotherapy and Chemotherapy
These treatments may be used alone or in combination with surgery, depending on the cancer type and stage.

Multidisciplinary Care
Head and neck cancer treatment is coordinated through a multidisciplinary team (MDT), involving ENT surgeons, medical and radiation oncologists, radiologists, pathologists, speech pathologists, dietitians, and specialist nurses.

When to See an ENT Surgeon

Referral to an ENT surgeon is recommended if:

A neck lump persists for more than 2–3 weeks
Mouth ulcers lasting longer than 2 weeks
There is persistent hoarseness or swallowing difficulty
Symptoms are unexplained or worsening
There is concern for head and neck malignancy

Cutting-edge ENT care with a focus on patient outcomes

Our specialists bring a wealth of ENT experience to the Shire. Our commitment to surgical excellence ensures every patient is provided with the best treatment options for their condition.