Neck Lumps & Cysts

Neck lumps and cysts can arise from various congenital, infectious, and inflammatory causes. While many are benign, proper diagnosis and treatment are crucial to prevent complications.

Below is an overview of common neck lumps and cysts, their causes, symptoms, risk factors, and treatment options.

Overview

Branchial cleft cysts are congenital anomalies that develop due to incomplete closure of the branchial clefts (embryonic structures that form parts of the head and neck). They typically present as painless, fluctuant swellings on the side of the neck.

Causes

  • Failure of the branchial apparatus to completely regress during embryonic development

Symptoms

  • Painless lump on the side of the neck, often appearing in childhood or early adulthood
  • Swelling that may become tender if infected
  • Drainage of fluid from a small opening in the skin

Risk Factors

  • Congenital condition present from birth
  • May become noticeable after an upper respiratory infection

Treatment Options

  • Surgical Excision – The definitive treatment to prevent recurrent infections
  • Antibiotics – If the cyst becomes infected before surgery

Overview

Thyroglossal duct cysts are the most common congenital neck cysts. They occur due to the incomplete closure of the thyroglossal duct, a structure that guides thyroid gland development.

Causes

  • Persistence of the thyroglossal duct after thyroid migration during embryonic development

Symptoms

  • Midline neck lump, usually below the hyoid bone
  • Moves up when swallowing or sticking out the tongue
  • May become painful or infected, leading to redness and swelling

Risk Factors

  • Congenital condition present from birth
  • Can become symptomatic after an upper respiratory infection

Treatment Options

  • Surgical Excision (Sistrunk Procedure) – Removes the cyst and part of the hyoid bone to prevent recurrence
  • Antibiotics – For infections prior to surgery

Overview

Dermoid cysts are benign, slow-growing cystic lesions that contain skin structures such as hair follicles, sebaceous glands, and sometimes teeth. They are typically found in the midline of the neck or face.

Causes

  • Congenital condition resulting from trapped skin and other tissues during embryonic development

Symptoms

  • Soft, non-tender lump in the midline of the neck or near the eyebrows
  • Slow-growing, usually present from birth
  • May become infected, leading to swelling and tenderness

Risk Factors

  • Congenital condition present from birth
  • More common in children and young adults

Treatment Options

  • Surgical Removal (Transoral or transcervical surgery) – the recommended treatment to prevent complications.
  • Antibiotics – If infected before surgery

Overview

Reactive lymphadenopathy refers to enlarged lymph nodes in response to infection, inflammation, or other stimuli. It is one of the most common causes of neck lumps.

Causes

  • Viral infections (e.g., cold, flu, Epstein-Barr virus, COVID-19)
  • Bacterial infections (e.g., strep throat, tuberculosis)
  • Inflammatory conditions (e.g., autoimmune diseases, sarcoidosis)

Symptoms

  • Swollen, tender lymph nodes in the neck
  • Associated symptoms such as fever, sore throat, or fatigue (depending on the cause)
  • Soft, mobile lumps that may decrease in size as the infection resolves

Risk Factors

  • Recent upper respiratory tract infection
  • Chronic inflammatory conditions
  • Exposure to bacterial or viral infections

Treatment Options

  • Observation – Many cases resolve on their own
  • Antibiotics – If a bacterial infection is the cause
  • Further Investigation – Persistent or hard lymph nodes may require imaging or biopsy to rule out malignancy

Conclusion

Dr Laura Wang specialises in the diagnosis and treatment of neck lumps and cysts, offering expert evaluation and personalised care. If you have a persistent or concerning lump in the neck, book a consultation today for a comprehensive assessment and tailored treatment plan.

Dr Laura Wang is a highly-experienced, fellowship-trained Endocrine and Head & Neck surgeon consulting and operating across Sydney.

Dr Wang holds both a Master of Surgery (MS) Degree and a Doctorate of Philosophy (PhD) in thyroid cancer surgery and performs a high-volume of thyroid and parathyroid surgeries. She was the first surgeon to be dual-trained in both head and neck cancer surgery (for benign and cancerous conditions), as well as microvascular reconstructive surgery at Memorial Sloan Kettering Cancer Centre in New York, which is the oldest cancer hospital in the world (founded in 1884).

Get in touch to book an appointment. Urgent appointments available for cancer patients.

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Endocrine and Head & Neck Surgeon
& Reconstructive Microvascular Surgeon
Phone

(02) 8076 4961

Fax

(02) 8080 8146

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