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Q&A with a doctor: What to do if you find a lump on your child’s neck

Posted on Aug. 29, 2018 ( comments)

Neck lumps are common in children — and a big source of worry for their parents. Lumps range from a harmless temporary swelling of the lymph nodes to infections or growths that require medical or surgical intervention.

To help lessen anxiety about lumps found in the neck, here are answers to some commonly asked questions:

Q: What are the possible causes for neck lumps?

A: There are three general categories:

  • Infectious: Most commonly viral but also bacterial, mycobacterial (e.g., Tuberculosis) and fungus infections (though rare) can cause enlargement of lymph nodes, soft tissue infections or abscesses in the neck that may or may not be painful.
  • Non-infectious growths: By far the most common of these in children is congenital cysts (such as branchial cleft cysts or thyroglossal duct cysts). Although they are benign, continued enlargement or infections may necessitate their removal. Benign tumors and rare malignant tumors may occur in children, though less commonly than in adults.
  • Immune related: Benign enlargement of lymph nodes related to allergies, skin conditions and autoimmune diseases may also appear as one or more small lumps in the neck.

Q: What are some diagnostic tests or ways to find out which condition is causing the swelling in my child’s neck?

A: Timing is the most important factor.

  • Temporary swelling: If a swelling or lump is present for only a few days and resolves on its own without treatment, it is likely infectious and in most cases requires no intervention (other than treating the infection).
  • Growing lesions: A lump that slowly enlarges but does not go down in size is often indicative of a tumor (if it occurs over weeks or months) or infectious (if it occurs rapidly over several days) and requires evaluation, including imaging (CT, ultrasound or MRI), lab tests, and in some cases a biopsy.
  • Large stable lesions: A lesion that is enlarged but stable and never changes in size is more likely to be a benign tumor or congenital (inborn) cyst. Imaging studies are useful in these cases.

Q: What are the treatment options for these conditions?

A: Treatment varies depending on the cause.

  • Infectious causes: Antibiotics (or other drugs as appropriate for the infection). At times when antibiotics are not effective, surgical incision and drainage may be necessary.
  • Growths: Biopsy and/or surgical removal may be necessary in many cases.
  • Immune-related lesions: You may need to consult with an immunologist, allergist or rheumatologist to determine the particular cause, and treatments that suppress the immune system may be suggested.

As you can see, a variety of conditions can produce neck swelling or lumps in children — and not all of them are worrisome or even require treatment. See your child’s pediatrician or an ear, nose and throat specialist for more information.

Make an appointment with an ear, nose and throat doctor

MultiCare ENT providers treat both children and adults. Find a MultiCare ENT

About The Author

Oliaei_Sepehr Sepehr Oliaei, MD

Sepehr Oliaei, MD, is an otolaryngologist (ear, nose and throat specialist) at MultiCare ENT, Sinus & Allergy Specialists - Tacoma. To schedule an appointment or evaluation, call 253-403-0065.

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