Prevalence of Pathological Entities in Neck Masses: A Study of 1208 Consecutive Cases

Many head and neck diseases manifest as neck masses with a wide range of pathologies from developmental lesions to malignancies. However, there is a lack of large-scale studies about the relative prevalence of these lesions in the neck region. This retrospective study was conducted to assess the distribution of neck masses related to gender, age, pathology, and anatomical location.Patients and During a 13-year period (1996–2009), the medical records of 1,208 patients with neck masses were collected from the department of pathology at Loghman educational hospital in Tehran, Iran. The cases were reviewed for data on gender, age, the type of origin tissue, the type of lesion, and the anatomical location. Comparisons between genders, age groups, and tissue origins were performed using the Chi-square test. The significance level was set at P < 0.05. All statistical tests were performed with SPSS 20 software. Over a period of 13 years, a total of 1,208 patients (617 men and 591 women) had neck masses resected for pathological assessments. The median age of presentation was 42.1 (ranging from 6 to 83 years). Among the 1,208 cases, 33 cases (2.7%) developed in the pediatric group (≤ 15 years old), 466 cases (38.6 %) developed in the young adult group (16 to 40 years of age), and 709 cases (58.7%) developed in the adult group (≥ 40 years old). Both the inflammatory/infectious and neoplastic lesions were more common in the older adult group with 129 and 433 cases, respectively. The Chi-square test showed significant differences between the genders and the different types of lesions (P = 0.000) and between the different age groups and the different types of lesions (P = 0.000). The anterior triangle (n = 654; 54.1%) was the most common anatomical site for the neck masses, followed by the midline and anterior neck (n = 548; 45.4%), and the posterior triangle (n = 6; 0.5%). The age and location of neck masses are the most important variables. The data in this study showed that the neoplastic lesions (including metastatic lesions) were the most common neck masses and the anterior triangle was the most common anatomical location. In addition, age can play an important role in differential diagnosis. Therefore, any mass in the neck, especially in older patients, located in the anterior triangle must be considered neoplastic until proven otherwise.