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Neck Lumps Notes

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This is an extract of our Neck Lumps document, which we sell as part of our ENT Notes collection written by the top tier of University Of Leicester students.

The following is a more accessble plain text extract of the PDF sample above, taken from our ENT Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Neck lumps 80:20 rule
- Paediatric neck lumps o 20% malignanct o 80% benign
- Adult neck lumps o 80% malignant o 20% benign

Salivary gland lumps

Parotid 80% benign, 20% malignant Submandibular 50% benign 50% malignant Sublingual 80% malignant 20% benign

20:40 rule
- Age < 20 years o Inflammatory neck nodes e.g due to tonsillitis o Congenital lesions e.g thyroglossal cyst, branchial cyst o Lymphoma
- Age 20-40 years o Salivary gland pathology (calculi, infection, tumour) o Thyroid pathology (tumour, thyroiditis, goiter) o Chronic infection (TB, HIV)
- Age > 40 years o Primary/secondary malignant disease

Paediatric neck lumpsMainly benign (80:20) Commonly anterior to sternocleidomastoid i.e in anterior triangle Isolated neck lump in posterior triangle has increase risk of being malignant

Thyroglossal cyst-

Commonest midline mass in children Formed from a persistent thyroglossal duct o Embryological remnant as thyroid descends, remains connected to tongue via thyroglossal duct. Normally atrophie and closes before birth) Fibrous cyst arises at any point along route of duct o Most commonly below hyoid bone Moves on swallowing or sticking out tounge Usually asymptomatic, apart from presence of lump If it becomes infected - pain and swelling persist

Management: USS - check they have a thyroid as cyst can be only thyroid tissue + excision

Dermoid cystUsually present as submental swellings in the midline Are dermal remnants occurring along lines of fusion in the embryo
- Lined by epidermis + may contain hair, teeth and debris
- Don't move on swallowing/tongue protrusion Management: excision

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