In clinical practice, we often encounter such a phenomenon that the development of tumor is caused by not paying attention to the painless lumps in the neck, and the tumor is found to have metastasized extensively until the disease is late. In the tumor checkups conducted by our hospital, the first disease detected is actually a neck lump.
The lumps in the neck that are not painful or itchy are more life-threatening
Many people think that this lump is not painful or itchy, so it probably doesn’t matter, right? Indeed, lumps without symptoms often do not attract attention and attention, only when the lump is accompanied by pain, redness, swelling, itching phenomenon, people feel that it is time to go to the hospital to take a look. In fact, symptomatic lumps should be taken seriously, and asymptomatic lumps, i.e. those that are not painful or itchy, should be more alert, especially painless lumps in the neck. This is because the incidence of tumor is higher in painless neck lumps; on the contrary, the more neck lumps with some symptoms, the greater the possibility of non-tumor.
Many neck tumors are mostly found unintentionally, and the clinical manifestation is only a neck lump without other symptoms, especially in the early stage of tumor. For example, thyroid cancer, thyroid adenoma, malignant lymphoma and various metastatic cancers (such as nasopharyngeal cancer, laryngeal cancer, lung cancer, cervical lymph node metastasis), salivary gland tumors (benign and malignant tumors of parotid gland or submandibular gland), hemangioma, lymphangioleioma, nerve sheath tumor, etc. are common in neck tumors, and most of them have no symptoms such as pain, skin redness and swelling. At this time, patients often ignore the possibility of tumors because of the absence of other symptoms, thus causing delay in treatment. Once some malignant tumors lose the opportunity of early diagnosis and treatment, when the disease develops further and then go to the doctor, they are often in advanced stage and it is difficult to obtain satisfactory treatment effect.
In addition, some tumor-like lesions in the neck that require surgical treatment, such as cheek cleft cyst and thyroglossal cyst, are mostly painless masses in the neck, which are easily ignored by patients. In contrast, some lumps in the neck with symptoms such as redness, swelling and pain should be considered more as atopic or non-atopic inflammatory masses such as septic inflammation and lymphatic tuberculosis. Of course, the advanced manifestations of some tumors cannot be completely excluded.
Several manifestations of neck tumor.
1.Inflammatory masses
It can be divided into acute and chronic. Acute inflammatory masses in the neck often manifest as local redness, swelling and pain in the neck, often accompanied by fever, and in severe cases, abscesses may appear. The other type is called chronic reactive lymph node hyperplasia in the neck, which often manifests clinically as multiple enlarged lymph nodes of different sizes, without pain and fever, and can last for months or years, and a few patients eventually become malignant lymphoma.
2.Congenital disease
Congenital cysts in the neck often include nail-shaped hyoid cysts. A nail-shaped hyoid cyst is a cyst that appears at the level of the hyoid bone in the neck. Female patients will have a laryngeal node in the neck similar to that of men, while male patients often show the phenomenon of a double laryngeal node, and the cyst can move with the movement of tongue extension.
3.Hemangioma
Various types of hemangiomas are also common tumors of the neck, mostly seen in children.
4.Benign tumors
The most common tumor is thyroid tumor, which is located on both sides of trachea or can occur on the surface of trachea, moving up and down with swallowing, and can be single or multiple. The next common tumor is salivary gland tumor, which is caused by parotid gland lesion and often appears as a mass under the earlobe or in front of the ear screen, which is clinically called parotid gland mixed tumor. There is another type of benign parotid tumor that occurs in middle-aged and elderly people over 55 years of age. The tumor is mostly located under the earlobe and can be unilateral or bilateral, which is clinically called lymphatic papillary adenoma.
Malignant tumors
Malignant tumors of the neck can be divided into two categories: primary or metastatic.
1.Primary malignant tumors
The most common one in the neck is thyroid cancer, and the incidence of thyroid cancer in China is increasing year by year. The disease occurs in young and middle-aged women, and its early symptoms are no different from benign thyroid disease, but it can be clearly diagnosed by the metastatic lymph nodes in the neck. The next most common is salivary gland tumor. Early lesions are similar to benign lesions. In advanced stages, facial paralysis, difficulty in opening the mouth, facial numbness, and deviation of the tongue tip to the diseased side when extending the tongue may occur. When the tumor occurs in parotid gland, about 10% is malignant, and if it occurs in submandibular gland, about 50% is malignant, so it should be paid attention to.
There is another type of malignant tumor in the neck, malignant lymphoma.
This disease often starts with enlarged lymph nodes in the neck as the first symptom, and can also be accompanied by enlarged axillary or inguinal lymph nodes, often accompanied by fever, night sweats and widening of the mediastinum, and requires pathological examination for a clear diagnosis. Laryngeal cancer and hypopharyngeal cancer are also common tumors in the neck, and their clinical manifestations are hoarseness, sputum and blood, and enlarged lymph nodes in the neck.
2.Metastatic malignant tumor
The neck has a rich lymphatic system and receives lymphatic drainage from other parts of the body except the lower limbs, which is very easy to transfer tumors from other parts of the body to the neck, so it is sometimes very difficult to diagnose the primary lesion of metastatic cancer in the neck, but the clues of the primary lesion can often be found according to the location of the metastatic lesion.