Preventive Medicine Expert Forum
Neck Lump
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Neck Lump

Hello Doctor -

I was checking the other Doctor Forums and actually your forum seemed the best fit since you have a primary care back ground.  My Dad is a healthy 68 year old with no chronic diseases.  He has had a lump in his lower front neck, about an inch left of center for about 2 months.  The lump seems almost cyst like, it is bigger than a marble, maybe twice the size of a marble.  He can move it around without too much effort, its pliable, its not fixed per se, but it doesn't appear dermatological, meaning there is no redness on the skin or anything.  It doesn't hurt at all, is pliable, movable.  He went to his primary care doc and he said he shouldn't worry about it, but wants an ultrasound and then referral to a surgeon about removing it.  But the MD didn't offer a possible cause or diagnosis ... while we are waiting for the ultrasound wanted to get your take.  Also, my Dad said when he was 20, he recalled having something similar and a doctor removed it, but he can't say if it was just like what he has now, nor does he recall what the diagnosis was previously.

Appreciate your thoughts, thanks
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Hi, thanks for your question. I can understand that you are concerned and justifiably so. These things can be scary. I agree broadly with your doctor's approach. Without seeing the lump myself, my differential diagnosis would include brachial cyst, thyroid mass, parathyroid mass, or enlarged lymph node. The way you describe it sounds most consistent with brachial cyst, which is a congenital problem that can recur and is benign. Thyroid and parathyroid masses are generally solid, not cystic, and while generally benign warrant evaluation because they can sometimes be cancerous. Finally an enlarged lymph node: we all have lymph nodes all over the body but they can get enlarged during infection or with certain cancers. I hope that is helpful. Let me know how the ultrasound and follow up goes.
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