The differential diagnosis of neck masses and lesions is broad and encompasses congenital masses, inflammatory/infectious disorders, as well as neoplasms. Workup consists of detailed history and physical examination, imaging, and, frequently needle biopsy. Depending on the diagnosis, treatment consists of antibiotic therapy, aspiration, or surgical excision/resection. The anatomy of the neck is complex, and surgical intervention requires detailed knowledge of the relevant anatomy and adjacent structures as well as knowledge of its complications.

Sarcomas of the head and neck are rare tumors accounting for approximately 2 percent of all head and neck cancers with approximately 1000 cases diagnosed each year in the United States. Patients that develop sarcomas in this region generally present with a palpable mass, local skin changes, or symptoms arising from site specific complications such as hoarseness, nasal obstruction or cranial nerve deficits. Imaging studies are useful in the in the complete examination of the patient and allow for preoperative staging and planning of reconstruction.

Nasopharyngeal carcinoma is a distinct epidemiological, pathological, and clinical entity. Progress in defining its carcinogenetic evolution and understanding its association with the Epstein-Barr virus has been made. Therapeutically, radiation therapy has constituted the major therapeutic modality for many years. Recent evidence suggests that the concurrent administration of chemotherapy during radiation therapy significantly improves survival rates, at least in nonendemic areas.

The most common neoplasm of the hypopharynx is squamous cell carcinoma. This is generally linked to traditional head and neck carcinogenic factors with an additional associated with conditions such as Plummer Vinson Syndrome. Patients present with dysphagia, throat pain, or nodal metastatic disease. Advanced presentation is common due to insidious nature of tumors in this subsite, and a rich lymphatic drainage leading to regional metastasis. Upfront treatment is generally non-surgical with single modality radiation for early stages, and chemoradiation for intermediate and advanced stages.

Oropharyngeal neoplasms (OPNs) can include a broad differential of benign and malignant processes. Although the differential of OPN is broad, one must first differentiate a neoplastic from non-neoplastic process. This is best accomplished with tissue diagnosis.  HPV positive oropharygneal squamous cell carcinoma (OPSCC) is the most significant neoplastic entity in this anatomic area, given its increasing incidence.

Disorders of the temporomandibular joint are relatively common, presenting in 5-15% of the general population. There are two distinct anatomic causes of TMJ disorders, those caused by injury to the myofascial structures and those caused by injury to the joint itself, it is crucial to be able to identify the source of the symptoms as the treatment options differ based on the source.

Stomatitis refers to a broad group of inflammatory and ulcerative lesions of the oral cavity. Clinical context and physical exam--often combined with pathologic testing--are key to diagnosis and effective treatment.