What should you know about a lump on the posterior neck?

The posterior neck includes skin, soft tissue and chains of lymph nodes. A lump may follow a scalp irritation, skin cyst, muscle strain or nearby infection. A clinician will consider whether it is soft or firm, mobile or fixed, painful or painless, and whether the skin over it has changed. A neck lump can be a presentation of head and neck cancer or lymphoma, but a lump does not by itself show that either condition is present.

If no obvious source is found, examination may be followed by imaging or other tests. Thyroid cancer usually concerns tissue at the front of the neck, although neck assessment considers the whole region. Cancer of unknown primary is a specialist term used only when a malignant process has been identified but its starting site remains unclear.

Make a brief record of when you first noticed the lump and whether its size or mobility changes. Check for recent scalp sores, dental problems, sore throat, ear symptoms or skin inflammation, but avoid repeated pressing because this can irritate the area. Book a clinical review for a persistent or unexplained lump. Bring a list of medicines and describe fever, night sweats, weight change, swallowing difficulty or voice changes if present.

Seek urgent help for breathing difficulty, inability to swallow saliva, rapidly expanding swelling, severe pain with neck stiffness, or a high fever with marked illness. Arrange prompt review if the lump is hard, fixed, steadily enlarging, associated with unexplained weight loss or night sweats, or remains after an infection has settled. Urgency comes from these warning features, not from the location alone.

Ask whether the lump feels like a lymph node or arises from another tissue, whether the scalp and throat need checking, and whether imaging is needed. Ask how long to monitor it, which changes should trigger earlier review, and whether referral to a head-and-neck or oncology service is appropriate.