What should you know about a midline neck lump?

The centre of the neck contains the thyroid gland, windpipe, swallowing passage and nearby lymph nodes. A lump can arise from a thyroid nodule, a fluid-filled cyst, inflammation, an enlarged lymph node or another growth. A midline neck lump is not enough to identify its cause. Thyroid cancer can present as a thyroid lump; head and neck cancer or lymphoma can involve neck nodes. In some cases, doctors find abnormal cells before locating where they began, described as cancer of unknown primary.

Book a clinical assessment if the lump persists, enlarges, feels firm or fixed, or is accompanied by voice change, swallowing difficulty, unexplained weight change or night sweats. The clinician may feel the lump, examine the mouth and throat, request an ultrasound, and arrange blood tests or a needle sample when indicated. Depending on the findings, the next discussion may involve [Thyroid Cancer](/conditions/thyroid-cancer/), [Head and Neck Cancer](/conditions/head-and-neck-cancer/), [Lymphoma](/conditions/lymphoma/) or [Cancer of Unknown Primary](/conditions/cancer-of-unknown-primary/).

Seek emergency care if the swelling causes difficulty breathing, noisy breathing, inability to swallow saliva or rapidly worsening throat tightness. Seek prompt medical review for a lump that grows quickly, becomes painful with fever, or is linked with new weakness, severe dehydration or marked difficulty swallowing. Do not wait for a routine appointment if breathing or swallowing is becoming unsafe.

Where is the lump located in relation to the thyroid and lymph nodes? Does it move when I swallow or stick out my tongue? Which examination or scan is needed? Would a needle sample clarify the diagnosis? What changes should I monitor? If thyroid surgery is discussed, what part would be removed and how would voice or calcium levels be monitored?