There is a small hard lump in the muscle

If we touch our neck and find a small lump, it is likely a neck lump. There are many reasons for this situation. If it is not a malignant tumor, it actually does not have much impact on the patient. But if it is a malignant tumor, it must be removed in time. Expert statistics show that 80% of neck tumors are malignant tumors. Therefore, everyone must pay attention to the situation where there is a small hard lump in the muscle area.

Neck masses are common in clinical practice. Neck masses have complex tissue origins, different biological characteristics, and different treatment options. Skandalakis statistics show that among non-thyroid masses, 80% of neck masses are tumors; among tumors, 80% are malignant; among malignant tumors, 80% are metastatic; and among metastatic malignant tumors, 80% of the primary lesions are located above the clavicle.

The course of inflammatory neck masses is usually 7 days, the course of tumorous neck masses is usually 7 months, and the course of congenital malformation neck masses is usually 7 years.

In terms of age, infants and young children mostly suffer from congenital masses, such as thyroglossal duct cysts, branchial cleft cysts, cystic hygromas, etc.; adolescent patients mostly suffer from inflammatory lymphadenopathy; young and middle-aged patients should be alert to malignant tumors; and elderly patients mostly suffer from metastatic malignant tumors.

In terms of location, thyrohyoid cysts and thyroid tumors are often located in the midline area of ​​the neck, branchial cleft cysts, salivary gland tumors, cervical schwannomas, and carotid body tumors are often located in the lateral neck area, and lymphangioma and metastatic cancers from the lungs and digestive tract are often located in the posterior neck area.

In terms of the nature of the tumor, malignant tumors of the neck are generally hard and have poor mobility. Metastatic cancer in the neck may cause multiple lumps, but the tenderness is not very obvious. Benign neck tumors are generally of medium texture, with clear boundaries and good mobility. Branchial cleft cysts, cystic hygromas, and epidermoid cysts are cystic tumors, but some thyroid metastatic cancers can also appear cystic.

Inflammatory masses in the neck have symptoms of redness, swelling, heat and pain. Acute cases have systemic symptoms including fever, fatigue, loss of appetite and increased total white blood cell count. When an abscess is formed, there will be obvious tenderness and pitting edema on the local skin, and superficial abscesses can be detected with obvious fluctuation.

Congenital masses in the neck, including thyrohyoid cyst and branchial cleft cyst. Thyrohyoid cysts are mostly located in the anterior midline of the neck, mostly on the thyrohyoid membrane and thyroid cartilage; the mass is cystic and moves up and down with swallowing. Branchial cleft cysts and fistulas are mostly unilateral, and a few are bilateral. Some patients are diagnosed at birth, but most are not discovered until adolescence, usually because the cysts enlarge or become infected. The lump is soft and fluctuating to the touch. When infected, it forms an abscess, which may rupture on its own and become a draining sinus. In cases with branchial cleft fistula, the external opening is usually very small and located at the anterior edge of the sternocleidomastoid muscle. Intermittent milky, mucous, or purulent material may be discharged from the external opening. The location and course of branchial cleft cysts and fistulas vary depending on the branchial cleft or branchial sac from which they originate. Cervical schwannomas grow slowly and have a long history. Cervical schwannomas are often round or oval, sometimes lobed, and are tough to the touch, with clear boundaries and a smooth surface. The mass can move left and right along the nerve axis, but not up and down. Carotid body tumors may not cause any symptoms in the early stages, but as the tumor grows larger, there may be a feeling of distension and pain. The lumps are mostly located in the anterior and inferior part of the mandibular angle, and a few bulge toward the pharyngeal side. The lump is round or oval in shape, with clear boundaries and a tough texture. The carotid artery pulse can be felt on the surface of the tumor, and vascular bruits may be detected by auscultation. When the tumor invades or compresses the vagus nerve, hoarseness and coughing when eating may occur; if it affects the sympathetic nerves, the pupil of the affected side may constrict, the palpebral fissure may become smaller, and sweating on the affected side of the face may decrease or disappear; if the hypoglossal nerve is damaged, the tongue muscles on the affected side may atrophy, and the tongue may deviate to the healthy side when it is extended. Malignant lumps in the neck are most commonly caused by metastatic cancer to the cervical lymph nodes. Cervical lymph node metastasis mostly occurs in adults over middle age. It presents as a painless mass that progressively enlarges on one or both sides of the neck. In the early stage of the disease, most of the lumps are single, small, hard and have poor mobility. As the disease progresses, the number of lumps increases and they fuse with each other. The lump is adhered and fixed to the skin. When the tumor is large, it compresses organs, esophagus, and nerves, causing corresponding symptoms and signs. Some squamous cell carcinomas and thyroid cancers may become cystic due to tissue necrosis and liquefaction in the metastatic tumor. In some cases, the tumor may invade the skin and cause skin ulceration, bleeding, secondary infection, etc.