A lump in the neck is one of the most common reasons patients are referred to an otolaryngologist and head and neck surgeon. The neck contains a dense collection of structures — lymph nodes, salivary glands, blood vessels, the thyroid gland, and more — and a mass in this region can arise from any of them. While the cause is benign in the majority of cases, a neck mass should never be dismissed without evaluation.

Dr. Samarrai’s training in otolaryngology and head and neck surgery gives her specific expertise in evaluating and managing neck masses, including those arising from the thyroid gland and lymphatic system.

A general rule in head and neck surgery: any neck mass in an adult that persists for more than two to four weeks warrants evaluation by a specialist. This is especially true for masses that are hard, fixed, painless, or accompanied by voice changes, difficulty swallowing, or unexplained weight loss.

Common causes of neck masses

Enlarged Lymph Nodes

The most common cause — often reactive to infection, but persistent enlargement requires evaluation

Thyroid Nodules

Growths within the thyroid gland, the majority of which are benign — but some require biopsy

Salivary Gland Masses

Arising from the parotid, submandibular, or sublingual glands — usually benign but surgically treated

Congenital Cysts

Branchial cleft cysts and thyroglossal duct cysts — developmental remnants that can become infected

Lipomas & Sebaceous Cysts

Benign soft tissue masses — often soft, mobile, and slow-growing

Malignant Masses

Lymphoma, thyroid cancer, or metastatic disease — less common but require prompt identification

Red flags — when to seek prompt evaluation

While most neck masses are benign, certain features should prompt earlier evaluation:

A neck mass that has been present for more than four weeks without explanation
A hard or fixed mass that does not move easily under the skin
A painless mass — pain actually makes malignancy less likely; a painless lump is more concerning
Associated voice changes, hoarseness, or difficulty swallowing
Unexplained weight loss, night sweats, or fatigue
A history of tobacco or alcohol use — significant risk factors for head and neck cancers
A rapidly enlarging mass

Thyroid nodules — what you need to know

Thyroid nodules are extremely common — the majority are discovered incidentally on imaging performed for other reasons. Most are benign, but a minority require biopsy to rule out thyroid cancer, which is one of the most treatable cancers when caught early.

Evaluation of a thyroid nodule typically involves:

Ultrasound — the primary imaging tool for characterizing thyroid nodules. Size, composition, and specific ultrasound features guide the decision about whether biopsy is needed
Fine needle aspiration (FNA) biopsy — a minimally invasive procedure in which a thin needle samples cells from the nodule for pathological analysis. Performed under ultrasound guidance
Thyroid function tests — blood tests to assess whether the thyroid is functioning normally

Head & Neck Surgery Expertise Neck mass evaluation requires subspecialty training. The differential diagnosis of a neck mass spans a wide range of conditions — from reactive lymphadenopathy to thyroid cancer to lymphoma. Getting the right diagnosis requires a thorough clinical examination, appropriate imaging, and familiarity with the full spectrum of head and neck pathology. Dr. Samarrai’s training in otolaryngology and head and neck surgery provides exactly this expertise.

What to expect at your evaluation

History and physical examination

Dr. Samarrai will take a thorough history including how long the mass has been present, any associated symptoms, and relevant medical and social history. A complete head and neck examination includes palpation of the mass and all neck lymph node regions, and examination of the oral cavity, throat, and larynx.

Flexible laryngoscopy if indicated

In-office scope examination of the throat and voice box to evaluate for lesions that may not be visible on external examination — particularly important when voice changes or swallowing difficulty are present.

Imaging

Ultrasound is the first-line imaging for thyroid nodules and many neck masses. CT or MRI may be recommended for deeper masses or when malignancy is suspected.

Biopsy or referral when indicated

Depending on findings, fine needle aspiration biopsy may be recommended. Surgical excision or referral to a multidisciplinary team may be appropriate for specific diagnoses.

Frequently asked questions

I found a lump in my neck — should I be worried?

The majority of neck masses are benign — enlarged lymph nodes from a recent infection are by far the most common cause. However, any neck mass that persists beyond four weeks, is painless, hard, or fixed, or is accompanied by other symptoms should be evaluated by a specialist. The goal is not to alarm you but to make sure the diagnosis is correct.

My doctor found a thyroid nodule on imaging — what now?

An incidentally discovered thyroid nodule should be evaluated with a dedicated thyroid ultrasound to characterize its features. Based on the ultrasound findings, your doctor will determine whether follow-up imaging, biopsy, or no further action is needed. Most nodules do not require biopsy, and the vast majority that are biopsied are benign.

Is a fine needle aspiration biopsy painful?

FNA biopsy is well tolerated by most patients. The procedure uses a very thin needle — similar to a routine blood draw — and is performed under ultrasound guidance to ensure accuracy. Local anesthetic is typically applied. The discomfort is generally minimal and brief.

My lymph nodes have been swollen for weeks — is that normal?

Lymph nodes commonly enlarge in response to infection and typically resolve within a few weeks. Persistent enlargement beyond four to six weeks without a clear cause warrants evaluation. This is especially true if the lymph nodes are painless, hard, or if you have other symptoms such as night sweats, fatigue, or weight loss.

Serving Brooklyn & Staten Island

Seaside ENT sees patients at 6818 3rd Ave, Brooklyn, NY 11220 in Bay Ridge and 1191 Forest Ave, Staten Island, NY 10310. Dr. Samarrai speaks both Arabic and English and has subspecialty training in head and neck surgery. Most major insurance plans are accepted.

Head & Neck Surgery | Brooklyn & Staten Island

Found a lump in your neck?

Call Seaside ENT to schedule a neck mass evaluation with Dr. Samarrai. Most insurance accepted.

Call (917) 992-3873

Brooklyn & Staten Island