Pynnonnen et al identified features of a neck mass that may indicate a high risk of malignancy. A lesion with one of these "red flags" may benefit from more aggressive evaluation. The authors are from multiple institutions in the United States.
Patient selection: adult with a neck mass
Characteristics of a neck mass in an adult suspicious for malignancy:
(1) diameter > 1.5 cm
(2) absence of an infectious etiology
(3) mass present >= 2 weeks OR uncertain duration
(4) firm texture to the mass
(5) ulceration of overlying skin
(6) reduced mobility ("fixed")
(7) nontender mass
where:
• A cystic lesion is often benign but a malignant tumor may appear to be cystic especially if there is central necrosis.
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