Examination for cervical masses.

Identification of cervical masses requires careful systematic examination of the head and neck. Important landmarks and major glands and muscles should be palpated and the upper aerodigestive tract examined with a mirror. If a mass is found and the cause is unclear, certain factors should be considered: the patient's age and history, the physical findings, and the location of the mass. Any mass of unknown cause that fails to respond to treatment within two to three weeks requires endoscopic evaluation of the mucosa of the upper aerodigestive tract and subsequent open biopsy. Such an aggressive approach will spare the patient inappropriate delays in determining definitive diagnosis and avoid inappropriate biopsy of a metastatic node containing squamous cell carcinoma primary to the aerodigestive tract. This results in optimum care of a patient with a cervical mass.