Definition & Overview
A neck tumour is an abnormal mass or growth that develops in the neck. These tumours can be found in the thyroid glands, throat, oesophagus, the larynx, voice box, windpipe, and the salivary glands. Just like any abnormal growths, neck tumours can be benign or malignant. Malignant tumours lead to the development of neck cancer. Studies show that 90% of head and neck cancers are squamous cell carcinomas, while the rest are adenocarcinomas, sarcomas, and lymphomas. Patients diagnosed with neck tumours may seek treatment from head and neck cancer specialists or oncologists.
Causes of the Condition
The development of neck tumours is associated with the following:
- Tobacco use, including cigarettes and cigars
- Alcoholic beverages
- Human papillomavirus or HPV
- Epstein-Barr virus
- Excessive consumption of preserved and salted foods, especially during childhood
- Occupational exposure to asbestos, synthetic fibres, and wood dust
Studies show that as high as 75% of all head and neck cancers are caused by frequent and excessive consumption of tobacco and alcohol over an extended period of time. People who consume both tobacco and alcohol also face a higher risk than those who consume only tobacco or only alcohol.
Human papillomavirus, on the other hand, is linked with oropharyngeal cancers, such as tumours on the tonsils, which can cause any of the following types of neck cancers:
- Squamous cell carcinoma – These are tumours caused by squamous cells, or thin flat cells found in the tissues that make up the skin surface and the linings of the body's cavities, such as the mouth
- Desmoid tumour or fibromatosis of the head and neck
Some squamous neck tumours are also metastatic in nature, in which the squamous cell cancer spreads to the neck without any clear indication as to where the cancer initially formed.
The key symptoms of neck tumours include:
- An abnormal lump or mass in the neck, which is usually painless but steadily grows in size
- Swollen lymph nodes
- Voice changes
- Mouth sores or ulcers
- Neck pain
- Bleeding, which tends to occur in the latter stages of the disease
- Blood in saliva or phlegm
- Swallowing problems
- Skin changes
- Persistent earache
Early detection of the above symptoms could lead to a prompt diagnosis, which in turn could increase a patient’s chances of fully recovering from the condition. To diagnose the condition, patients undergo a variety of medical tests that examine the various tissues of the neck, respiratory tract, and upper digestive tract. These may include:
- Physical exam
- Review of medical history
- MRI scan
- CT scan
- PET scan
Patients who need a biopsy may undergo any of the following:
- Fine needle aspiration biopsy, in which a piece of tissue or some fluid from the tumour is aspirated using a thin needle
- Core needle biopsy, in which tissue from the suspected tumour is removed with a wide needle
- Excisional biopsy, in which the entire abnormal lump or growth is removed or excised through surgery.
An endoscopy is also a popular technique used in diagnosing neck tumours. It examines the organs and tissues inside the body to check for abnormal growths using an endoscope, a thin hollow tube with a camera and light scope attached at the end. The endoscope is inserted through a tiny skin incision or a natural opening in the body, such as the mouth or nose. If necessary, a biopsy can also be performed during an endoscopy.
A biopsy sample can then be tested using:
- Light and electron microscopy
- Epstein-Barr virus test
- HPV test
Who to See and Types of Treatments Available
Patients who suffer from symptoms linked with neck tumours can seek treatment from a general practitioner, who can run initial tests and make a referral to a head and neck cancer specialist if necessary. Malignant neck tumours are treated by an oncologist or oncologic surgeon.
Treatment options for neck tumours include:
- Excision surgery, which can be a radical, partial, or modified neck dissection
- Radiation therapy, which can be either external or internal; a new type of radiation therapy, intensity-modulated radiation therapy or 3D radiation therapy, can also be used
- Hyperfractionated radiotherapy, in which the total dose of radiation is broken down into smaller doses so that the patient can receive multiple doses in a day
The prognosis or the patient’s chances of recovering from a neck tumour depends on:
- The number of cancerous growths
- The size of the tumours
- The tumours’ response to initial treatment
- The results of microscopic tests performed on the tumour cells
- The patient’s age and general state of health
- The location of the tumour
- Other tumour markers involved
Some of the treatment options used for neck tumours may affect the functioning of the organs in the neck.
Forastiere A, Koch W, Trotti A, Sidransky D. “Head and neck cancer.” The New England Journal of Medicine. 2001 December;345:1890-1990. http://www.nejm.org/doi/full/10.1056/NEJMra001375
Haddad R, Shin DM. “Recent advances in head and neck cancer.” The New England Journal of Medicine. 2008; 359:1143-1154. http://www.nejm.org/doi/full/10.1056/NEJMra0707975