Smelly lump on the neck: what to know

An unpleasant smell can come from pus, trapped skin material, an open wound, or tissue breakdown. A lump may also be a swollen lymph node, a thyroid-related mass, or a lesion in the skin or nearby structures. A neck lump is a presentation of several conditions, and the lump itself cannot identify the cause.

Head and neck cancer, lymphoma, thyroid cancer, and cancer of unknown primary can involve a neck mass, but many neck lumps have non-cancer causes. Examination may include looking inside the mouth and throat, feeling the neck, and arranging imaging or a sample when needed.

Arrange a medical appointment if the lump persists, grows, becomes firm or fixed, opens, drains, or repeatedly develops an odour. Note when it appeared, whether it changes with meals or illness, and whether you have fever, dental problems, sore throat, voice change, swallowing difficulty, or weight change.

Keep the area clean and avoid squeezing, puncturing, or applying unprescribed creams. A clinician may treat infection, examine a thyroid or lymph node, or refer you for imaging and further tests. Do not delay review because the lump is not painful.

Seek urgent help if swelling makes breathing or swallowing difficult, bleeding will not stop, or you develop severe pain, rapidly increasing redness, high fever, confusion, or marked weakness. Prompt assessment is also needed for a persistent lump with night sweats, unexplained weight change, a change in voice, or difficulty swallowing.

Ask whether the lump seems to arise from skin, a lymph node, or the thyroid; whether drainage or infection is present; and whether imaging or a biopsy is appropriate. Ask which changes should trigger urgent review and whether treatment such as thyroid removal surgery is relevant to the findings.