Swellings of the Neck

THE HE BASIC anatomical configuration of the cervical region permits both local and adjacent sources to create the possible origin of swellings of the neck. Swellings within such contiguous areas as the floor of the mouth, parotid gland, base of tongue, pterygomaxillary space, trachea, esophagus, mediastinum, and infraclavicular areas may first be apparent clinically as enlargements in the neck rather than in the primary site. The majority of diseases which become manifest as a cervical swelling, other than the acute inflammatory conditions of children and the blood dyscrasias, arise from two sources. Pathologic changes in the thyroid gland constitute the most frequent single source of a mass in the neck, and carcinoma that has metastasized to the cervical lymph nodes comprises the second most prevalent source of a presenting mass in the neck. The high incidence of metastatic neoplasia makes it apparent that the cervical swelling is of secondary importance;