Cyst in Neck

Q: My dad has cysts in the neck. He has got the thyroid test and FNAC, but still neck swelling is there. After removal of some fluids from neck on FNAC, the report came normal, saying he doesn’t have any type of cancer. Still another doctor have doubts and suggested me to go for FNAC again. My question is why the swelling comes up again and again.
-By Pramod

Reply:

Usually, cystic swellings of the neck subside slowly on their own. If a neck swelling occurs again and again, there has to be a baseline cause for it.

Common Causes

Infection

Any chronic infection in the head and neck area can cause neck glands to enlarge. The glands may remain enlarged till the infection persists. This may happen in cases of long standing infections anywhere in the ear, nose, throat, skin, scalp, back of neck or sinuses.

People having frequent sore throat or sinus problems may have persistent swellings in the neck.

Some Infections Which May Give Neck Swellings

  • Peritonsillar abscess
  • Strep throat
  • Tonsillitis
  • Tuberculosis
  • Viral pharyngitis
  • Allergic pharyngitis

Allergy

Any lingering allergic condition such as runny nose, seasonal cough or itchiness may be associated with swelled lymph nodes in the neck

Neoplastic Conditions

Cancers or malignancy of any structure in the neck may give a neck swelling. Such swelling may arise from any structure in the neck like thyroid gland or salivary gland etc.

Typically, such swellings would have the following features:

  • They are usually hard to touch.
  • They are immobile, somewhat fixed to the structures beneath.
  • Malignant swellings grow in size and may give symptoms as difficulty in swallowing food or difficulty in breathing. This happens as they press upon the food pipe and the wind pipe in the neck.

Enlarged Thyroid Gland

Such a swelling may be purely cystic (fluid filled), solid or mixed in consistency.

Symptoms of thyroid disorder are present in such cases. They include-

  • Fast heart rate.
  • Disturbed sleep
  • Mood fluctuations
  • Change in weight (Loss or gain)
  • Feeling tired very often

Since the chances of malignancy are higher in older population, malignancy needs to be ruled out first. This is done by FNAC.

May be the FNAC done earlier had some technical error, and so your doctor wants to repeat it. FNAC is the most important investigation that can lead us towards diagnosing the swelling.

If it turns out to be clear, chances of some chronic infection in the area needs to be ruled out next.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Recurrent Cystic Swelling in the Neck

  1. Alina

    Two months ago, my throat got swollen and had difficulty swallowing. Since then, I have had two relapses but much less aggressive. I made two ultrasounds, the first within a period of relapse and the dimensions of the cyst was higher. This is the result of the second ultrasound that was done when the cyst was not symptomatic, “under mandibular, medial, over laryngeal, a cyst of 14 mm/10mm, with thin wall, containing fluid density, fine internal septa, avascular, no adenopathies laterocervical. Two of the doctors advised me to wait to see the evolution of the cyst, saying that it’s nothing urgent, but after the second ultrasound, cyst got swollen a bit, was painless and deflated in three days with inflammatory pills. What should I do? Thank you!

    Reply
    1. Buddy M.D. Post author

      It would be better to wait and watch.

      Since the cystic swelling is benign and harmless, taking any aggressive step, like surgical excision, is not advisable.

      Your cyst has responded to anti inflammatory medications. May be it doesn’t occur now. If it occurs, repeating the treatment once more would be better.

      Reply