A hard lump at the back of the neck

Hardness may reflect a cyst, calcified tissue, a prominent normal structure or an enlarged lymph node, among other causes. Head and neck cancers, lymphoma and thyroid cancer can present with neck lumps, but a hard lump is not itself a diagnosis of cancer.

People use hard to describe different findings: a firm rubbery node, a skin lump with a solid centre, or bone beneath thin tissue. The examiner determines whether the lump is in the skin or deeper, moves over surrounding tissue, is tender, or sits close to the skull or spine.

Timing and associated symptoms add context. A recent infection, scalp problem or dental issue can accompany reactive lymph nodes. Continued enlargement, fixation, persistent voice change, trouble swallowing, unexplained weight loss or drenching night sweats calls for timely investigation.

Make an appointment rather than repeatedly testing the lump with your fingers. Record when it appeared, whether its size changes and any recent infection or skin symptoms. Mention previous cancer, radiotherapy to the head or neck, immune suppression and any other lumps.

The clinician may inspect the scalp, skin, mouth and throat and feel other lymph-node areas. Ultrasound can help show whether a lump is solid or fluid-filled and which structure it belongs to. Needle sampling or another biopsy may follow when examination and imaging do not provide enough information.

Call for emergency help if the swelling is affecting breathing, if you cannot swallow saliva, or if rapid enlargement is accompanied by faintness. A hot, red and very painful area with fever or a marked decline in wellbeing needs same-day assessment for possible infection.

Arrange an earlier clinic review if the lump continues to enlarge, becomes fixed, or comes with progressive hoarseness, swallowing difficulty, coughing blood, unexplained weight loss or drenching night sweats.

Ask whether the lump seems to arise from skin, a lymph node or another structure, and which test would best clarify that. Find out how results will be communicated, what changes to watch for and whether referral to a head and neck or other specialist is appropriate.