Head and Neck Q8

A 58-year-old lorry driver presents with a lump in his neck. He first noticed it after recovering from a ‘cold’ 2 A 64-year-old gardener presents to the GP with a neck lump. The lump was discovered accidentally by his grandson two days ago. He denies dysphagia, odynophagia, haemoptysis, weight loss and loss of appetite. He is a smoker with 20 pack year history, and he drinks a pint of beer every day. He says he initially booked the appointment for an intermittent earache in his right ear that has been ongoing for 1 month, but stresses he is now more concerned about the neck lump. On examination, you feel a hard, fixed lump in the anterior triangle of the neck. Otoscopy is unremarkable bilaterally.

Which of the following is the best next step in the management of this patient?

  • A) Urgent referral to ENT
  • B) Routine referral to ENT
  • C) Home with reassurance
  • D) Home with reassurance and analgesia for the earache
  • E) Review in 6 weeks