We analysed 7, 307 outpatients who had visited our clinic in the Dokkyo University School of Medicine Hospital between 1974 and 1987. The number of patients with swelling of the neck was 346 (4.8%). Benign disease accounted for 218 cases (62.1%) and malignant disease 133 cases (37.9%). Malignant disease increased in patients over 50 years old, and exceeded the number of benign disease in those over 60 years old.
There were 171 cases of thyroid disease (35 malignant cases and 136 benign cases) and 180 cases of non-thyroid disease. The latter included 44 cases of inflammation (24.4%), 105 cases of tumors (58.3%) and 31 cases of congenital disease and miscellaneous (17.2%). Out of 105 tumor cases, primary malignant tumors were found in 13 cases, metastatic tumors below the clavicle were in 8 cases, metastatic tumors above the clavicle were in 73 cases, primary benign tumors were in 7 cases and primary unknown malignant tumors were in 4 cases.
In the frontal neck region, almost 80% of neck masses were benign disease and almost 90% were thyroid disease. In the lateral neck region, almost 60% were malignant disease. In the sternocleidomastoideus area, over 90% were metastatic tumors. The metastatic neck masses from the head and neck region were found in the upper and median parts of the neck. Metastatic tumors below the clavicle were found only in the lower part of the neck.
Almost 70% of the patients (230 out of 334 cases) with cervical masses were referred to our department by other departments or institutes. The patients were referred to our department slightly more than one year after noticing the first symptoms. The patients were first treated or diagnosed by referring doctors for a period of 44 days. We wish to enlighten the general public and doctors in other departments about these cervical masses.