ก้อนที่คอ Neck Mass_PTP

<h2>What Causes a Lump in the Neck?</h2>
<h2>Common Causes and Locations</h2>
A lump in the neck (Neck Mass) is a lump that can be felt or seen in various areas of the neck, such as under the chin, under the ear, on the side of the neck, or around the larynx. It is commonly found in all age groups. These lumps may be small and asymptomatic or large enough to cause discomfort or be life-threatening. The causes of neck lumps can be divided into four main groups:
<ul>
<li>Congenital Mass (Congenital Mass) These lumps are often found in children or present from birth, caused by developmental abnormalities such as cysts located in the midline of the neck that move with swallowing or tongue protrusion, lateral neck lumps that often enlarge after infection, large cysts caused by abnormal lymphatic systems commonly seen in infants or young children, and lumps containing fat, hair, or other tissues usually found near bones. Although these lumps are mainly found in children, some types may show symptoms as they grow older.</li>
<li>Inflammatory or Infectious Mass (Inflammatory/ Infectious Mass) Commonly found in both children and adults, often accompanied by symptoms such as pain, swelling, redness, or fever. The lumps are usually soft, tender, and movable. Common causes include swollen lymph nodes from throat or tonsil infections or tuberculosis, salivary gland inflammation especially under the chin, infections in the mouth or teeth spreading to the neck, lumps from injury or subcutaneous hematoma, and in some cases, allergic reactions which are usually temporary and resolve on their own.</li>
<li>Thyroid Mass (Thyroid Mass) Common in adults, especially in the front of the neck. Causes may include thyroid enlargement, cysts, thyroiditis, tumors, or thyroid cancer. These lumps are often relatively firm; some patients may experience hoarseness, difficulty swallowing, or a feeling of tightness in the neck. A specialist should evaluate to determine the cause and appropriate treatment.</li>
<li>Tumor (Tumor) This group is divided into two types: benign tumors such as soft, movable, painless lipomas under the skin, sebaceous cysts found on the back of the neck or hairline, and slowly growing salivary gland tumors usually found under the chin or jaw area; and malignant tumors such as lymphoma which may present with multiple large lumps along with symptoms like weight loss and night sweats, or cancers spreading from other organs such as the nasal cavity, tongue, or lungs to the neck area.</li>
</ul>
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<h2>What Symptoms Should You Watch For? How Can a Neck Lump Indicate Serious Disease?</h2>
Observing the characteristics of a neck lump is important because some lumps may be signs of serious diseases such as cancer or tumors that require urgent diagnosis and treatment. The lump characteristics that should be especially concerning include:
<ul>
<li>Rapidly growing lump, increasing in size continuously, or not shrinking within 2-4 weeks</li>
<li>Hard lump that does not move when palpated or has an irregular surface, often associated with tumors or cancer rather than benign lumps</li>
<li>Lump that is painless or, in some cases, more painful than usual, which may indicate malignancy, especially if there is no history of inflammation or injury</li>
<li>Skin over the lump shows abnormalities such as swelling, redness, warmth, or ulcers, usually related to inflammation or infection; however, chronic ulcers or skin fixed to the lump may indicate cancer invading the skin</li>
<li>Accompanying abnormal symptoms such as unexplained weight loss, night sweats, hoarseness, difficulty swallowing, painful swallowing, breathing difficulties, ear fullness, radiating ear pain, nasal congestion, nosebleeds, or oral ulcers. These symptoms may indicate disease progression or compression of vital organs</li>
<li>Lump that does not shrink after treatment should raise suspicion of tumor or cancer because lumps caused by infection or inflammation usually shrink after treatment. If the lump persists or grows again, especially in patients over 40 years old, smokers, alcohol drinkers, those with a family history of cancer, or immunocompromised individuals, the risk of tumor or cancer in the neck is higher than in the general population</li>
</ul>
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Neck lumps in children are usually not serious and are caused by easily treatable conditions such as infections or congenital abnormalities. However, adults over 40 years old should be more cautious because neck lumps may be associated with more serious diseases such as certain tumors or cancers. Therefore, they should undergo evaluation by an ear, nose, and throat specialist or head and neck surgeon at a medical facility equipped with comprehensive medical tools and expert medical teams. In cases where the neck lump grows large enough to compress the trachea or esophagus causing breathing difficulty, swallowing obstruction, or hoarseness, immediate hospital evaluation and urgent treatment are necessary as dangerous complications may develop rapidly.
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<h2>How to Examine a Neck Lump?</h2>
<h2>Diagnostic Steps and Considerations by Physicians</h2>
The choice of appropriate diagnostic methods depends on the lump’s characteristics, patient history, and associated symptoms. Accurate diagnosis leads to appropriate treatment plans, reduces the risk of complications, and increases the chance of complete recovery, especially in serious cases like cancer. Because the causes of lumps vary, diagnostic steps differ but generally include:
<ul>
<li>History Taking such as duration of the lump, sore throat, difficulty swallowing, weight loss, fever, past medical history, previous infections, family history of cancer, or other risk factors like smoking and alcohol consumption</li>
<li>Physical Examination such as palpating the lump to assess size, shape, firmness, mobility, number of lumps, location, as well as examination of the mouth, throat, ears, nose, and other lymph nodes</li>
<li>Neck Ultrasound (Neck Ultrasound) is an initial test to evaluate whether the lump is solid or cystic, whether it has clear boundaries, and helps identify abnormalities in lymph nodes, thyroid gland, or salivary glands</li>
<li>Blood Tests such as thyroid hormone tests (TSH, FT4, FT3) to assess thyroid function if a thyroid lump is suspected, and complete blood count (CBC) to detect signs of infection, anemia, or certain blood diseases like leukemia</li>
<li>Fine Needle Aspiration (FNA) is the standard method for lumps suspected to be tumors or cancer, using a small needle to extract cells from the lump for pathological examination to differentiate between benign, inflammatory, or malignant lumps with high accuracy</li>
<li>Computed Tomography (CT Scan) produces cross-sectional images of the neck to assess the size, location, relationship with adjacent organs, and spread of the lump</li>
<li>Magnetic Resonance Imaging (MRI) shows detailed soft tissue images, suitable for evaluating tumor invasion in complex areas such as the skull base or oral cavity, usually performed when indicated</li>
<li>Excisional Biopsy is surgical removal of the lump or tissue for detailed pathological examination to confirm diagnosis when other methods are inconclusive</li>
<li>Thyroid Scan uses radioactive substances to check thyroid lump activity, suitable for suspected hyperthyroidism or specific types of thyroid lumps</li>
<li>Flexible Endoscopy of the Throat or Nasal Cavity is used when a deep or hidden lump is suspected, such as nasopharyngeal cancer, laryngeal cancer, or oral cavity lumps not visible externally</li>
</ul>
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<h2>How to Treat a Neck Lump?</h2>
<h2>Treatment Options You Should Know</h2>
Treatment of neck lumps depends on the cause and characteristics of each lump. Physicians will evaluate based on appropriate diagnostic results to plan targeted and effective care. The main treatment approaches include:
<ul>
<li>Lumps from Infection or Inflammation are treated with antibiotics or antiviral drugs according to the identified pathogen, along with supportive care such as warm compresses, rest, and surgical drainage if abscesses are present. Generally, the lump will shrink once the infection is resolved.</li>
<li>Congenital Lumps such as thyroglossal duct cysts and branchial cleft cysts are recommended for surgical removal to reduce the risk of recurrent infection and prevent future complications.</li>
<li>Thyroid Lumps treatment depends on the lump’s type and patient symptoms. It may include antithyroid medications to reduce size and control symptoms in hyperthyroidism, or close monitoring. For large lumps causing compression or suspected cancer, surgery is recommended, possibly combined with radioactive iodine therapy. Chemotherapy and ultrasound-guided thermal ablation, a new popular technique, may be options for patients who cannot or do not want surgery.</li>
<li>Benign Tumors such as lipomas or sebaceous cysts are usually considered for surgery if the lump is large or causes discomfort.</li>
<li>Malignant Tumors such as lymphoma or cancers spreading to the neck are usually treated with a combination of surgery, radiation therapy, and chemotherapy depending on the type, stage, and patient’s condition.</li>
</ul>
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For lumps with unclear causes or types, doctors will schedule follow-up examinations and closely monitor symptoms to assess changes and response to initial treatment.
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Neck lumps can be signs of various diseases ranging from simple infections to cancer. If you find a neck lump with abnormal features such as rapid growth, hardness, immobility, or associated symptoms like weight loss, hoarseness, or difficulty swallowing, you should promptly seek evaluation by a specialist.
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At Phyathai Phaholyothin Hospital, we have a team of ear, nose, and throat specialists and head and neck surgeons equipped with comprehensive medical tools and technology, ready to provide diagnosis and initiate treatment immediately to increase the chance of cure, reduce complications, and help patients regain good health and confidence in life.
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Dr. Jakkrit Worakulpanich
Department of Ear, Nose, and Throat
Phyathai Phaholyothin Hospital

A lump in the neck can be found in people of all ages. Sometimes it may be just a temporary condition that can resolve on its own, but in many cases, it can be a sign of a progressing abnormality, such as chronic infection, thyroid gland disease, or serious conditions like cancer. Therefore, understanding the causes and characteristics of lumps that should be cautious of, as well as seeking appropriate diagnostic evaluation, is important and should not be overlooked.

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