Head & Neck Lumps

Question 1

Head & Neck lump red flags

Answer 1

Persistent & progressive
Odonyphagia & Weight loss
Referred ear pain
Unilateral nasal obstruction or bleeding
Stridor
Hoarseness
Painless neck lump
Non healing ulcers

Answer 2

Lymph node (85%)
- Infective (systemic symptoms, painful swelling)
- Malignant spread
- Haematological malignancy

Thyroid nodule & Thyroglossal cyst (8%)
- Thyroid nodule (moves with swallowing)
- Thyroglossal duct (moves with sticking tongue out)

Other (7%)
- Cancer (HPV 16, smoking, drinking)
- Aneurysm (pulsatile)
- Branchial cyst
- Salivary gland pathology
- Pharyngeal pouch
- Skin or connective tissue pathology

Answer 3

Thyroid nodule => moves with swallowing
Thyroglossal duct cyst => moves when stick tongue out