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November 28, 1980

Neck Mass—A Mixed Blessing

Author Affiliations

University of Pittsburgh School of Medicine Pittsburgh Ear, Nose and Throat Associates

JAMA. 1980;244(21):2415. doi:10.1001/jama.1980.03310210017012

To the Editor.—  The presence of a neck mass in an adult man aged 50 years or older is a mixed blessing. The positive aspect of the blessing is that if not for the neck mass, the primary lesion in the base of the tongue, nasopharynx, or hypopharynx may not have been discovered until it became too far advanced to be curable. The negative aspect of the blessing occurs when the cancer deposit in the neck is violated by performing a biopsy in an effort to make a diagnosis before doing a routine ear, nose, and throat examination that in most cases would have uncovered an obvious primary site.Although great advances have been made in medicine since the 1950s, the lump in the neck remains problematic. Martin and Romieu1 (1952) stated that an asymmetric enlargement of one or more cervical lymph nodes in the adult is almost always