Clinical Case Database / Category: Case Based Discussion

Painful and increased swelling in the lower neck

Publication details

Rohit Pratap MRCS, Amir Farboud MBChB
Foundation Years Journal, volume 2, issue 2, p.107 (123Doc Education, London, February 2008)


You are asked to see a 24-year-old man with an 8 week history of a persistent, increasing painful swelling in the lower neck. He had no other symptoms, in particular, any ENT or constitutional symptoms. Of note, in the past he had noticed a discharge from this area which settled spontaneously. He had no other past medical history of note. He was a non-smoker and drinker. You examine the patient and fit nd a well-looking man, who is apyrexial. He has a flu uctuant swelling measuring 5 cm in the lower midline of his neck. He has no other lumps to feel in the neck.

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Rohit Pratap MRCS (Corresponding author)

Specialist ENT Registrar
ENT Head and Neck Surgery Department
Norfolk and Norwich University Hospital
Colney lane

Amir Farboud MBChB

ENT Head and Neck Surgery Department
Norfolk and Norwich University Hospital


1. Roland NJ, Fenton J, Bhalla RK. Management of a lump in the neck. Hosp Med. 2001;4:62(4):205–209.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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