Author(s)
Marco A. Ayala, MD
Kevin J. Sykes, PhD MPH
Myron W. Yencha, MD
Affiliation(s)
University of Kansas Medical Center
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to explain the differences in types of pathology seen during the evaluation of a neck mass in the military recruit population. Objectives: 1) To evaluate the types of neck masses seen in the military recruit population; and 2) to determine the incidence of medical conditions disqualifying recruits from military training during the evaluation of a neck mass. Study Design: Retrospective cohort study of all patients evaluated for a neck mass by a combined Navy and Veteran Affairs otolaryngology clinic from January 1, 2011-September 1, 2014. Military recruits were identified and compared to Veteran Affairs members, active duty (non-recruit) members, and active duty family dependents. Methods: One hundred and fifty patients were evaluated during the study period. Electronic medical records were reviewed for all patients. Data collection included demographic information, comorbidities, pathology, and imaging results. Results: Of the 150 patients evaluated, 46 (31%) were recruits of which 10 (22%) were disqualified from military training. Reactive lymphadenopathy was the most common diagnosis seen in 18 (39%) recruits followed by neck abscess/infection (20%), congenital neck mass (15%), other benign lesions (19%), and malignancy in 3 (7%) of recruits. In the 52 Veteran Affairs patients and 24 active duty (non-recruit) members, the incidence of malignancy during a neck mass workup was 25% and 17% respectively. Conclusions: The majority of neck mass evaluations in military recruits represent reactive lymphadenopathy with a significant decrease in the incidence of malignancy compared to the veteran population. However, malignancy was observed in 7% of recruits evaluated in the otolaryngology clinic for a neck mass. These findings confirm the need for careful evaluation of all patients presenting with a neck mass.