10
Diagnosis
6. Oral cavity or
oropharyngeal
ulcer
Visible ulceration of mass, tenderness to palpation, or decreased
tongue mobility may indicate a malignancy.
7. Recent voice
change
May indicate a malignancy of the laryngeal or pharyngeal
structures.
8. Recent hearing loss
ipsilateral to the
neck mass
May indicate a nasopharyngeal malignancy with unilateral
middle ear effusion.
9. Nasal obstruction
and epistaxis
ipsilateral to the
neck mass
May indicate an ulcerated malignancy in the nose or
nasopharynx.
10. Unexplained
weight loss
Cachexia is common in cancer patients.
Head and neck cancer in particular may cause difficulty
swallowing and cause wasting simply from inadequate
nutrition.
11. History of
treatment for
head and neck
malignancy
including skin,
salivary gland, or
aerodigestive sites
Prior head and neck malignancy places a patient at risk for local
or regional (nodal) recurrence or a second malignancy.
Patients with prior radiation treatment are at risk for a
secondary neoplasm decades later.
12. Non-tender neck
mass
An infectious or inflammatory neck mass may be painful or
tender.
A non-tender mass is less likely infection or inflammation and
more likely neoplastic.
13. Tonsil asymmetry
May indicate a malignancy within the larger tonsil.
14. Skin lesions
(face, neck, scalp
included)
Cutaneous malignancy can metastasize to the cervical lymph
nodes.
Table 3. Characteristics Suspicious for Malignancy in the
Presence of a Neck Mass (cont'd)
