Wrap up of the week

The differential diagnosis of neck masses can be considered in three categories: congenital, inflammatory, and neoplastic. It is essential to differentiate between them. The patient’s history and physical examination can be very helpful. The most common risk factors for head and neck malignancies are smoking and HPV infection.

During physical examination, you should look for red flags including a stridor and a solid mass fixed to underlying structures. When malignant disease is suspected, a fine needle aspiration (FNA) is the most effective diagnostic tool, as it is cost-effective and minimally invasive. Endoscopic evaluation is an important complement to the head and neck examination, but not as effective as a primary diagnostic tool.

Lastly, the occurrence of cancer may differ around the world, having knowledge about the prevalence of different cancers per country can be of great help when making a differential diagnosis. The treatment of different types of head and neck cancers varies, and are not discussed in this course.