Delays in Malignant Neck Mass Diagnosis: Missed Opportunities in Clinical Decision-Making

INTRODUCTION: Neck masses are a common presenting symptom for head and neck cancers and lymphomas. However, the diagnostic pathway for these malignancies remains underexplored. METHODS: The authors reviewed a subset of adult patients with neck masses ultimately diagnosed as malignant. Clinical decisions by primary care physicians (PCPs) and otolaryngologists were assessed. The authors evaluated diagnostic time intervals and biopsy diagnostic rates. Eighteen percent of patients followed the most streamlined diagnostic pathway and experienced a median total diagnostic interval of 6 days. CONCLUSIONS: Most patients did not undergo the most optimal diagnostic process. Antibiotic use, PCP-ordered imaging, and delayed or unsuccessful biopsies were common contributors to delay.