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Hard lump getting bigger in size at the back of the neck. No pain. Could this be cancer?

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Hi there I am a 36yr old male and I have a hard lump on the back of my neck under the skin (if I put my pinky finger flush with the back of my ear it is about where my index finger rests whilst doing that)it throbs but does not move but has gotten a bit bigger in the last 9mths ( was the size of my pinky nail and is now about the size of my thumb nail.
I have plucked any hairs around it thinking it may have been an ingrown hair and I had even had someone squeeze at it ( I know not advisable but I just wanted relief from the throbbing) No pus comes out and there seems to be no hair trapped in there either. I have a freckled complexion and there is a fecked on top of the lump but not a big freckle. I am afraid it may be cancer? I have no other symptoms such as a rash or anything and it is not itchy it is just under the skin not above it or anything. I have no other lumps anywhere else.
Posted Mon, 16 Jul 2012 in Skin Cancer
Answered by Dr. Anil Grover 2 hours later
Hi there,

Thanks for writing in.
I am a medical specialist with an additional degree in cardiology.
I read your question with diligence and understand your anxiety to find out whether is it cancer? Firstly, by the description of it I feel this is a lymph node.
While it is true that cancerous nodes tend to be hard and immobile as well as painless, there are other reasons for lymph nodes to be hard.

My feeling is, depending on the description you you are giving is very consistent with a reactive lymph node that may have had some scarring. It may also simply be a lymph node that did not shrink back down to un feel able size after it was enlarged during infection. This is quite common and termed shotty lymph nodes.

If the node is not getting larger there was really little to worry about. If you notice that the node does seem to be getting larger as per your description, it is a good idea to have it checked out. A doctor after complete physical examination may decide to do needle aspiration or remove it for pathological examination called biopsy.

Also, the area you describe would be a little unusual for a cancer to first present (though not impossible).

Scarring of lymph nodes can occur when the lymph node itself gets infected throbbing point towards infection. Typically with infections the lymph nodes swell not because they themselves are infected, but because they are processing the infection information and presenting it to the immune system. In essence, the lymph node is the command center giving the order to the immune cell soldier to go out and find the infection that looks like this.

When the lymph node itself becomes infected, inflammation sets in. This results in parts of the lymph node being damaged. Then scar tissue sets in to help heal the lymph node.

Typically, as a cancer invades a lymph node and begins to expand there the cancer cells clump together into a solid ball. As the mass grows, the lymph node expands. This gives the characteristic hard feeling rather than the rubbery feeling of normal reactive lymph nodes. Often along with expanding in the lymph node, the cancer invades into the surrounding tissue. This causes the lymph node to become fixed to the surrounding tissue rather than be movable as a typical lymph node is.

It can be quite difficult to distinguish between a scarred lymph node and a malignant (cancerous) lymph node. In these cases, generally time will tell. Cancerous nodes tend to get bigger while a scarred lymph node does not. If there are other symptoms suggestive of a possible cancer, generally physicians will choose to biopsy the node rather than wait. Biopsies will also be done if the node seems a little more suspicious than a typical scarred lymph node.

The best thing to do any time you are concerned about a lymph node that seems to be changing or one that meets the descriptions of a cancerous lymph node is to show it to doctor.

I hope this helps. If anything is not clear please ask a follow up query. I will be most pleased to answer.

With Best Wishes.

Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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