Neck Lump and Thyroid Nodule: Causes, Tests and Why a Lump Should Be Checked

What it involves

MedlinePlus defines a neck lump as any lump, bump or swelling in the neck, and a thyroid nodule as a growth in the thyroid gland, which sits at the front of the neck just above where the collarbones meet in the middle.

Who this is for

• Patients who feel or see a new lump on the side or front of the neck
• Patients whose neck lump is growing, hard, painless or has lasted more than a couple of weeks
• Patients who were told on an imaging test that they have a thyroid nodule
• Patients with a lump plus a hoarse voice, trouble swallowing, weight loss or a racing heart

What to expect

• Questions about where the lump is, how long it has been there and whether it has changed in size
• A physical exam of the neck, thyroid and lymph nodes, and a review of symptoms and risk factors
• Thyroid blood tests, since the practice lists blood work among its services, and in-house lab services at West Palm Beach
• A referral for an ultrasound or biopsy when the exam calls for it

Common causes of a neck lump

MedlinePlus says the most common neck lumps are enlarged lymph nodes, which can be caused by bacterial or viral infection, cancer or other rare causes. Swollen salivary glands under the jaw may come from infection, mumps, a stone in a duct or a tumor. Lumps in the muscles often follow injury or spasm, and lumps in or just under the skin are often cysts. The thyroid can swell or form lumps from thyroid disease or cancer. The swollen lymph nodes guide and the skin lumps and cysts guide cover two of these.

Why every neck lump gets looked at

The encyclopedia is firm that all neck lumps in children and adults should be checked right away by a provider. In children, most are infections that need quick treatment. As adults age, the likelihood of cancer rises, especially in people who smoke or drink heavily, though most lumps in adults are not cancer. It also says most thyroid cancers grow very slowly and are often cured with surgery, even if present for several years. The point of the visit is not to alarm you, but to sort out which kind of lump it is.

What a thyroid nodule is

MedlinePlus says thyroid nodules are caused by an overgrowth of cells in the gland, and that they may be benign, thyroid cancer or, rarely, other cancers or infections. They may be fluid-filled cysts, single or multiple, and some produce thyroid hormone. They are very common, occur more often in women and become likelier with age. Only a few are due to thyroid cancer. A nodule is more likely to be cancer if it is hard, stuck to nearby structures, you have a family history of thyroid cancer, a voice change, or past radiation to the head or neck.

Symptoms a nodule can cause

Most thyroid nodules cause no symptoms and are found on a routine exam or an imaging test done for another reason. Large ones can press on nearby structures, causing a visible swelling, a hoarse or changing voice, neck pain, trouble breathing when lying flat or trouble swallowing. A nodule that makes too much thyroid hormone can cause sweating, a fast pulse, nervousness, tremor and weight loss. Hoarseness has its own page, the hoarseness guide, and swallowing trouble is covered in the difficulty swallowing guide.

Tests MedlinePlus lists

If a provider finds a nodule, MedlinePlus says tests may include a TSH level and other thyroid blood tests, a thyroid ultrasound, a nuclear medicine thyroid scan and a fine needle aspiration biopsy. For a neck lump in general it adds CT of the head or neck and a lymph node biopsy. This practice can arrange the blood tests described in the thyroid blood tests guide and follows thyroid care; ultrasound, scans and biopsies are referrals to imaging centers and specialists.

What happens afterward

MedlinePlus says surgery to remove all or part of the thyroid may be recommended if the nodule is cancer, causes swallowing or breathing symptoms, has an inconclusive biopsy or makes too much hormone. Radioiodine can treat nodules that make too much hormone, and either approach can lead to lifelong low thyroid function that needs treatment. Many nodules that are benign are simply watched with follow-up. A bacterial infection behind a lump is treated with antibiotics. Call 911 for a lump with trouble breathing.

Sources

• MedlinePlus — Neck lump
• MedlinePlus — Thyroid nodule