Swellings in the neck require medical attention. Although most neck swellings are benign in nature, it is imperative that thorough examination and investigation is carried out to rule out malignancy.

• A significant family history of head and neck cancers eg. Nasopharyngeal cancer
• A history of smoking , drinking and chewing betel nuts
• When neck swellings do not subside and respond to medication
• When a neck swelling is associated with symptoms of nose bleeding, hearing loss, eating difficulty or hoarseness of voice

Neck swellings can arise from different head and neck regions. These areas can broadly be classified into:

• Parotid (salivary gland) tumours
• Lymph nodes
• Salivary gland stones

• Submandibular (salivary gland) tumours
• Lymph nodes
• Salivary gland stones

• Thyroid tumours
• Thyroid cysts
• Thyroglossal duct cyst

Intraoperative picture of a large salivary tumour	A Patient with a large thyroid gland

Tests that are commonly carried out are:

1. Fine needle aspiration cytology
This involves inserting a fine needle and suctioning cells from the neck swelling to ascertain the nature before surgery. This is done in the clinic under topical anesthesia. The tissue specimen is sent to the laboratory for evaluation.

2. Radiological evaluation
CT or MRI scanning of the neck is often undertaken to obtain more information about a neck swelling. From the radiological images, one is often able to assess the size and nature of the neck growth.