Congenital neck pathologies symptoms
A mass or swelling in the neck may be present at birth (congenital) or develop later in childhood or adulthood (acquired). The mass is usually benign, but it can also be malignant. The type and location of the neck mass will determine the best course of treatment.
Wryneck or Torticollis
A condition that affects the sternocleidomastoid muscle in the neck causes a child to tilt their head and chin to one side. This is called torticollis, which is most common in newborns. In older children, torticollis can be due to a variety of reasons such as tightening or shortening of the neck muscles.
Klippel-Feil Syndrome
A bone disorder that occurs from birth, this condition is characterized by the abnormal joining (fusion) of two or more spinal bones in the neck. The fusion results in a short, narrow neck and a low hairline at the back of the head.
Parotid and submandibular glands
There are three parotid and submandibular salivary glands in the lateral neck that extend from the sternocleidomastoid muscles to the body of the mandible. These glands produce a range of different chemicals including sebaceous fluid, mucus, and urea.
Abnormal agenesis of the parotid glands can cause enlargement and pain in the neck. It is usually diagnosed by examination and imaging.
Symptoms of parotid and submandibular lymphadenopathy include fever, chills, cough, hoarseness, sore throat, and neck stiffness. Other signs include numbness, tingling, and coldness of the hands or fingers.
Supraclavicular triangle masses
A supraclavicular triangle is a thickened, pulsatile mass of the neck that can be felt behind the subclavian artery. The mass is most commonly caused by a recurrent infection and can be easily treated with antibiotics.
Neck masses in adults
Family physicians often encounter neck masses in their patients. A careful history and physical exam are important to make a diagnosis of the cause of the mass. A chest radiograph should be ordered if the mass is large or has been present for a long time.
Lymph nodes in the neck are the most common site of a neck mass. In most cases, they resolve with no treatment. However, in some patients with a positive family history or suspicious lymph nodes, a fine-needle aspiration biopsy is recommended.
Other uncommon neck masses in the lateral neck involve branchial anomalies and thyroglossal duct cysts. The latter may develop anywhere in the sternocleidomastoid or atrioventricular canal. These masses can be slow-growing and painless. The presence of a history of infection, spontaneous discharge, and previous incision and drainage may help to determine the diagnosis.
Other uncommon neck masses in the lateral neck may be associated with thyroid disorders such as adenomas and goiters. Serologic tests, such as serum thyroid function testing, should be performed to exclude a metabolic disorder and other uncommon causes of neck masses.
