Parotid Lumps In The Upper Neck
It may go undetected for years but caution is called for once found.
The swelling of the upper part of the neck is a common problem and the common diagnosis in the region includes a
cervical lymph node, parotid tumour or a parapharyngeal tumour.
In Asia, a mass in this area, in particular among the Chinese community, is commonly associated with a spread from the cancer of the nose (also called Nasopharyngeal Cancer). The lymph nodes are the portal of cancer spread; they become enlarged usually over a period of months before the patient is aware of the swelling. There can also be accompanying symptoms in this group of patients, such as bleeding from the nose or mouth, hearing loss, ear block, ear ringing or nose discharge.
Unfortunately, 60% of all patients who present upper neck lumps for the first time are found to have nose cancer. Thus, having a neck lump can be the first sign of cancer.
One common diagnosis of an upper neck lump is that of a parotid tumour. The parotid gland is one of two large
salivary glands in the head and neck (the other is the submandibular gland). It is sited at the angle of the jaw in
front of the ear. Lumps can grow inside the gland and present as enlargement of the parotid gland. There is no
known cause for parotid enlargement. This is the same gland that enlarges during a mumps infection.
Fortunately, 80% of the tumours in the parotid gland are benign and the rest being malignant (or cancerous). Typically, the patients would have known about the mass for several months or even years. Parotid lumps present without any symptoms in the majority of cases.
The presence of pain in and rapid growth of a parotid mass make one suspect a parotid cancer. A fine needle test can be done but the final diagnosis can only be ascertained on removal of the lump. The risk of parotid cancer includes rapid enlargement, invasion of the tumour to the surrounding tissues, and spread to the lymph nodes of the neck.