What should you know about a rock-hard lump in the neck?

A neck lump may come from a lymph node, thyroid tissue, salivary gland, skin, muscle or another structure. Infection can enlarge a node, while a thyroid nodule or another non-cancerous growth can also feel firm. Head and neck cancer, lymphoma, thyroid cancer and cancer of unknown primary are conditions clinicians may consider when the examination or history raises concern. A neck lump is a presentation of these conditions in some people; its feel alone cannot identify the cause.

The clinician may check the mouth, throat, ears, thyroid and lymph-node areas, then arrange an ultrasound or other imaging. If a tissue diagnosis is needed, a needle sample or biopsy may be discussed. Note when the lump appeared, whether it changes with swallowing and whether it is growing or painful.

Arrange an appointment for a new, persistent or enlarging lump, especially if it is hard or fixed. Bring a list of medicines and recent infections, and mention smoking, alcohol exposure, voice change, swallowing symptoms or unexplained weight change. Do not repeatedly press or massage the area, since that can irritate tissue and make changes harder to judge.

Seek urgent help for difficulty breathing, inability to swallow saliva, rapidly increasing swelling, severe weakness or bleeding. Contact a clinician promptly for a lump with persistent hoarseness, trouble swallowing, night sweats, fever without a clear infection or unexplained weight loss. These warning features call for assessment; they do not establish a cancer diagnosis.

Where does the lump seem to arise? Do I need ultrasound, imaging or a needle sample? What symptoms should prompt faster review? When should I expect the result and the next appointment?