In clinical practice, we often come across some people who have lumps in the neck, but they are not painful and are not taken seriously, but these lumps may be caused by malignant tumor metastasis, and many people do not come to the doctor until the lesion is late, and the treatment is delayed. Many neck tumors are found unintentionally and only manifest clinically as neck lumps without other symptoms, especially in the early stage of tumors. For example, thyroid cancer, nodular goiter, malignant lymphoma and various metastatic cancers in cervical lymph nodes (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 do not have symptoms such as pain, skin redness and swelling. At this time, patients often ignore the possibility of tumor because of no 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 masses: Inflammatory masses can be divided into acute and chronic. Acute inflammatory neck masses often manifest as localized 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 varying sizes, without pain or fever, and can last for months or years, and in a few patients may be malignant lymphoma. Congenital disorders Congenital cysts in the neck often include thyroglossal duct cysts. A thyroglossal duct cyst is a cyst that appears at the level of the hyoid bone in the neck. In female patients, a laryngeal node similar to that of males may appear in the neck, while male patients often present with a double laryngeal node phenomenon, and the cyst may move with tongue extension movements. Hemangiomas Various types of hemangiomas are also common tumors of the neck, mostly in children. Benign tumors The most common tumor is thyroid tumor, which is located on both sides of the trachea or on the surface of the trachea and moves up and down with swallowing, either singly or in multiples. 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 tumor of the parotid gland 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 adenolymphoma. Malignant tumors of the neck can be divided into two categories: primary and metastatic. The most common malignant tumor 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, and can also be accompanied by enlarged lymph nodes in the axilla or groin, often with fever, and requires pathological examination for a clear diagnosis. Laryngeal cancer and hypopharyngeal cancer are also common tumors of the neck. Clinical manifestations include hoarseness, blood in the sputum and enlarged lymph nodes in the neck, which can be clearly diagnosed by laryngoscopy. 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 clues to the primary lesion can often be found according to the location of the metastatic lesion. However, most metastatic masses in the lateral part of the neck originate from nasopharyngeal carcinoma, laryngeal carcinoma, thyroid carcinoma, malignant tumor of tonsil, etc. Metastatic masses in the root of the neck can also be cervical lymph node metastases from lung cancer and esophageal cancer. If there is a neck lump, it should be examined and treated in hospital as soon as possible to avoid delaying the disease. Our department has accumulated extremely rich experience in the diagnosis and treatment of neck masses, various head and neck tumors, and thyroid masses.