I have a BB sized lump where my preauricular node is. What are the possibilities?
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a BB sized lump where my preauricular lymph node is, right outside my right ear. My dermatologist, who is treating me for melanoma in situ, is sending me to an ENT this week to check it out, but said melanoma in situ cannot spread. I have no other symptoms. It is not tender and he described it as rubbery and movable. I discovered it a few weeks ago incidentally because my jaw hurt a little one day, so who knows how long it has been there. It has not changed in the two to three weeks I have known about it. What are the possible things it could be (your differential)? Should I have it biopsied, and does it sound like cancer?
Hello,
Welcome to icliniq.com.
For swelling in the pre-auricular area, my differentials are: 1. Lymph node enlargement. 2. Parotid gland swelling. 3. Skin tumor. 4. Parapharyngeal space growth. Since it is rubbery and movable, I feel it is more like a node only. Nevertheless, we need to investigate it. A fine needle aspiration cytological (FNAC) study will be required, but since the area is close to the branching of the facial nerve, we need to very careful with this investigation. An ultrasonogram of the swelling will be very useful for this. It demonstrates the likely contents of the swelling and indicates a diagnosis.The likelihood of cancer is there but not more than other possible differentials. Parotid tumors can occur in young individuals like you. They are not uncommon. Could you provide more details on the melanoma? Location, size, previous investigations, treatment being taken for it. Any intraoral pathology? Swelling/infection/enlarged tonsils/throat pain/increased phlegm? Any problem with scalp?Dandruff? Any treatment for those? Please revert back with details and we shall help you.
Patient's Query
Thank you doctor,
He felt it and said it was a 3 by 4 mm lump where the pre-auricular lymph node is. He felt around and said all other lymph nodes felt normal. It was also movable. I did not have any excess saliva, night sweats, fever, or fatigue. He said it is possible that it is not a mass, but just a hard lymph node that is backed up. He does not think it is a cyst because it is not painful. He diagnosed it as a lesion that is right under the skin and ordered an ultrasound. I am still scared it is cancer but have prayed a lot and know my ultrasound is tomorrow. Do you have any other thoughts? He said he was not too worried about it. I just stumbled upon it so he said it is possible it has been there for years.
Hello,
Welcome to icliniq.com.
Do not worry. You be positive. The features of a cancerous node are fixity to surrounding structures, excessive enlargement in a short span of time, hard nature, etc. In your case, with the features described by your ENT doctor, I can say with reasonable accuracy that the chances of it being cancer are less likely. With the ultrasound, we will have a good idea about what it is. It is quite possible that it is an old node that just remained swollen without healing completely. Probably the infection became subclinical whereas the node did not go back to its normal size and it remained so. I am also praying that it is just an old node. Ultrasound is a non-invasive procedure and you will be fine. Do write back to us tomorrow.
Patient's Query
Thank you doctor,
Here is the ultrasound. How does this look?
Hello,
Welcome back to icliniq.com.
Could you upload the radiologist's opinion or impression of the scan? This is the film that you have uploaded. Is the swelling any different? Have they asked for a cytological study?
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Otolaryngology (E.N.T)
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