Prevalence of Pathological Entities in Neck Masses: A Study of 1208 Consecutive Cases

Abstract

Background: Many head and neck diseases manifest as neck masses with a wide range of pathologies from developmental lesions to malignancies. However, there is a lack of large-scale studies about the relative prevalence of these lesions in the neck region. Objectives: This retrospective study was conducted to assess the distribution of neck masses related to gender, age, pathology, and anatomical location. Patients and Methods: During a 13-year period (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009), the medical records of 1,208 patients with neck masses were collected from the department of pathology at Loghman educational hospital in Tehran, Iran. The cases were reviewed for data on gender, age, the type of origin tissue, the type of lesion, and the anatomical location. Comparisons between genders, age groups, and tissue origins were performed using the Chi-square test. The significance level was set at P < 0.05. All statistical tests were performed with SPSS 20 software. Results: Over a period of 13 years, a total of 1,208 patients (617 men and 591 women) had neck masses resected for pathological assessments. The median age of presentation was 42.1 (ranging from 6 to 83 years). Among the 1,208 cases, 33 cases (2.7%) developed in the pediatric group (≤ 15 years old), 466 cases (38.6 %) developed in the young adult group (16 to 40 years of age), and 709 cases (58.7%) developed in the adult group (≥ 40 years old). Both the inflammatory/infectious and neoplastic lesions were more common in the older adult group with 129 and 433 cases, respectively. The Chi-square test showed significant differences between the genders and the different types of lesions (P = 0.000) and between the different age groups and the different types of lesions (P = 0.000). The anterior triangle (n = 654; 54.1%) was the most common anatomical site for the neck masses, followed by the midline and anterior neck (n = 548; 45.4%), and the posterior triangle (n = 6; 0.5%). Conclusions:The age and location of neck masses are the most important variables. The data in this study showed that the neoplastic lesions (including metastatic lesions) were the most common neck masses and the anterior triangle was the most common anatomical location. In addition, age can play an important role in differential diagnosis. Therefore, any mass in the neck, especially in older patients, located in the anterior triangle must be considered neoplastic until proven otherwise.

A Retrospective Study of Patients Presenting with Neck Masses to a Tertiary Care Center, Jeddah, Saudi Arabia

“…Other common origins for masses in our study included salivary glands and lymph nodes. Compared to our results, Irani et al (1) reported a higher prevalence of lymph node masses (34.6%) and studies by Irani et al (1) and Rathod and Parmar (15) reported a slightly lower rate of salivary gland masses (about 11%). This high incidence of thyroid masses could be attributed to the fact that thyroid disorders are relatively common among the Saudi population, with 7% of the population having hypothyroidism (16).…”

“…As regards the origin of the studied neck masses, about half the masses aroused from the thyroid gland. Our findings are in line with the results of previously published studies (1,15). A lower prevalence of thyroid masses (35.7%) was reported by Irani et al (1) in Tehran.…”

“…Our findings are in line with the results of previously published studies (1,15). A lower prevalence of thyroid masses (35.7%) was reported by Irani et al (1) in Tehran. Other common origins for masses in our study included salivary glands and lymph nodes.…”

“…The wide range of pathologies presented as neck masses include benign lesions to malignancies (1). Common causes for neck masses include lymphadenopathies (specific and non-specific, acute and chronic), metastatic carcinoma, lymphoma, thyroid masses (goiter, nodules, and cysts), and salivary gland swellings (sialadenitis, cysts, adenomas, and carcinomas) (2,3).…”

“…The common pediatric head and neck tumors are lymphomas (59%), rhabdomyosarcomas (13%), thyroid tumors (10%), nasopharyngeal carcinomas (5%), neuroblastomas (5%), nonrhabdomyosarcoma soft-tissue sarcomas (4.5%), salivary gland malignancies (2.5%), and malignant teratomas (1%) (12). It is known that a malignant neoplasm in the neck can arise as a primary tumor or as a metastasis from the upper aero digestive tract or a distant site (1). Head and neck cancers (HNC) are reported to be the ninth most common cancer worldwide.…”