Diagnosis and management of masses in the neck, with special emphasis on metastatic malignant disease.
The author presents an algorithmic approach to the diagnosis and treatment of neck masses and reviews individual neck mass entities. He stresses that, until proven otherwise, every adult neck mass should be treated as if it were malignant, and, prior to biopsy, should be worked up appropriately with head and neck exams and endoscopic evaluations in search of the primary tumor. This is important because there can be adverse effects to early, inappropriate biopsy--local wound complications, increased local recurrence, and increased distant metastases. In children, an initial biopsy of the mass after a complete physical examination is acceptable because the incidence of primary mucosal cancers in the pediatric age group is low. The role of panendoscopy for neck masses with a known primary mucosal carcinoma is reviewed in light of the high incidence of two simultaneous head and neck primaries. The technique, role, and timing of needle biopsy of neck masses is also discussed.
McGuirt
W F
WF
Department of Otolaryngology, Wake Forest University Medical Center.
D000293:Adolescent; D000328:Adult; D002648:Child; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D009333:Neck / Q000473:pathology*