Clinical and Pathological Study on Neck Masses.

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A statistical analysis was conducted of 279 patients with neck masses treated in the Department of Otolaryngology, Niigata University School of Medicine from 1981 to 1990. 7.6% of all 3, 654 hospitalized patients. The mean age was 50.3 years; 155 were males and 124 were females.There were 124 malignant tumors (44.4%), 95 benign tumors (34.1%), 29 inflammatory diseases (10.4%), 29 congenital diseases (10.4%) and two others. Malignant tumors predominated in males, and benign tumors in females; both were more common in patients over 50 years of age. Of the malignant tumors, 67 were metastatic lymphnodes, 21 were malignant lymphomas, 17 were thyroid cancers, and 14 were parotid cancers; there were five other miscellaneous lesions. All primary sites of the 67 metastatic lymphnodes were in the head and neck areas. The majority of benign tumors were 61 parotid tumors, 33 of which were pleomorphic adenomas. Of the inflammatory diseases, 11 were submandibular sialoadenitis and six were nonspecific cervical lymphadenitis. Most of the congenital diseases were lateral cervical cysts or cervical median cysts.Masses with spontaneous pain were suspected of being due to inflammatory diseases. Hard masses with tenderness, poor mobility and obscure margins were apt to be malignant tumors or inflammatory diseases. Soft masses with good mobility, distinct margins, and no tenderness were usually benign tumors or congenital diseases.It follows from the present findings that careful examination of the head and neck, keeping in mind the possibility of malignant tumors and particularly metastatic lymphnodes, is the first step in the identification of diseases causing neck masses. Careful consideration should precede decisions for open biopsy with special attention to the patient's history and local findings. Detailed inspection and palpation are essential in deciding the proper course of treatment.

Clinical and Pathological Study on Neck Masses.

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