MLA Domain 5 · Presentation
Neck lump
9 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.
classic presentation · 3
Hoarseness, fixed/hard nodule, rapid growth, cervical nodes, or stridor → suspected cancer pathway / urgent
Mediastinal mass with SVC obstruction, or airway/cord compression → oncological emergency
A persistent, firm, fixed neck lump in an ADULT (especially with smoking/alcohol, dysphagia, hoarseness, or an HPV risk)
recognised feature · 5
Persistent mouth ulcer/patch >3 weeks, hoarseness >3 weeks, unexplained neck lump, dysphagia, or a salivary lump with fa
Coronary artery aneurysms — the feared complication; incomplete Kawasaki in infants
Do not miss appendicitis — if in doubt, observe/image/operate
Any unilateral adult glue ear, a persistent neck node, or cranial nerve palsies → urgent ENT (nasendoscopy + biopsy)
Rapidly enlarging hard mass + stridor/hoarseness in the elderly → anaplastic — urgent airway/oncology
differential of the above · 1