A large lump on the back of the neck

Possible causes include an inflamed cyst, a collection related to infection, a benign fatty lump, or an enlarged lymph node responding to infection in the scalp, ear or throat. Lymphoma and other cancers can also present with a persistent neck mass. Appearance and touch alone cannot establish the cause.

Location, depth, tenderness, mobility and change over time help guide the examination. The clinician may inspect the scalp, mouth, throat, ears and thyroid and feel other lymph-node areas. Depending on those findings, ultrasound or another scan may be followed by a needle sample or biopsy.

Arrange a medical appointment if the lump is large, persists, enlarges, returns after treatment, or has no clear explanation. Note when it began and whether it changes with illness. Mention fever, scalp or dental infection, sore throat, swallowing changes, hoarseness, weight loss, drenching night sweats or other lumps. Do not squeeze, puncture or repeatedly massage it.

Seek emergency care if neck swelling makes breathing or swallowing difficult, grows rapidly, causes drooling, or occurs with severe illness, fainting or confusion. Obtain prompt medical assessment for spreading redness, marked warmth, severe pain, pus or fever, as these can accompany an infection that needs treatment. A hard, fixed or steadily enlarging lump also warrants timely review even when it does not hurt.

Ask which structure the lump seems to arise from, whether imaging is needed and what would determine the need for sampling. Clarify how soon to return if it changes, whether antibiotics are appropriate only when infection is suspected, and how results from any scan or biopsy will be communicated.