Neck Lump

There are two multidisciplinary neck lump clinics a week (Monday afternoon and Friday mornings) at Lauriston Building, and one a month at St John’s Hospital. 

These are intended to provide rapid assessment of all neck lumps causing clinical concern. The clinic includes immediate access to ultrasound and both fine needle and core biopsies.

The Scottish Referral Guidelines for Suspected Cancer include a head, neck and thyroid cancer section.

The recommendation is to refer an unexplained neck or parotid lump lasting 3 weeks or more as urgent suspicion of cancer.

The clinician should examine of the neck to ascertain the position, mobility and consistency of any neck lump in patients presenting with head and neck symptoms.

The guidance also notes:

• Lymph nodes felt behind the sternomastoid muscle are more likely to be reactive and less concerning than those found in front of it or below the angle of the jaw
•  Intradermal lumps, which are often sebaceous cysts and lipomas, are superficial and can be differentiated from deeper lumps by palpation. They are often found on the scalp and do not require referral on a head and neck pathway.
• Considering risk factors including smoking, alcohol and recreational drug use.

Referrers should give a good description of the neck lump – position, size, shape, consistency, mobility and overlying skin changes. Small, mobile, and rubbery lumps are likely to be reactive lymph nodes and in the absence of the above concerning features can be followed up clinically to check for resolution or further investigation / referral where indicated.

Please see the Neck Lump and Throat Cancer Risk Assessment page for further detail about related symptoms and risks.

Please do not prearrange ultrasound scans as the clinic provides the appropriate scanning in the clinic. Interpretation of ultrasound in the neck is a challenging area, and the radiologists involved with our clinic have built up a significant expertise.

C.M & A.H – 17-02-26