Neck masses: benign or malignant? Sorting out the causes by age-group.

Differential diagnosis of cervical masses varies with the age of the patient. In children, neck masses are most likely to be inflammatory or congenital, and evaluation may include routine laboratory evaluation, skin tests, chest films, computed tomography and/or magnetic resonance imaging of the neck, and, possibly, fine-needle aspiration of the mass. The workup in young adults is similar to that in children. In older patients (greater than 40 years), however, the likelihood of malignant disease increases significantly. These patients should have formal endoscopy with biopsy of any suspicious lesions before an open biopsy of the neck mass is performed.