In Asia, a mass in this area is in particular the Chinese 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 and enlarged usually over a period of months before the patient is aware. There can also be accompanying symptoms in this group of patient such as bleeding from the nose or mouth, hearing loss, ear block, ear ringing or nose discharge. Unfortunately, the upper neck lump represents 60% of all patients who present for the first time who are found to have nose cancer. Thus, having a neck lump can be the first sign of cancer.