Longstanding Lump Under Jaw-Biopsy Needed

[herewego071600]

I am a 25 yr old Male. While after having some extensive tooth work done (I have severe decay that still persists)  about two years ago, I noticed that I had sore spot under my right jaw.  When I felt the spot, I could feel a small (bean-sized) lump that was positioned in a hollow space next to the interior of my jaw.  The lump seems round, firm (but not hard), and I can freely move it up the other (cheek side) of my jaw.  You cannot feel it if I look straight ahead, but if I tilt my head, you can feel it and start moving it.  

Knowing that that the same area on the left side got sore (although no lump) when I had molar problems, I assumed this lump was dental related and really did not worry about it.  

During the intervening two years (during which I let my molar problems get worse) I would notice that the area would sometimes be sore when touched and sometimes would not be.  I tried to not touch it too much, because the way I could move it up my jaw freaked me out.  Still, I assumed it was infected tissue or something.  

Then, recently, for whatever reason, I started playing with it again and became very nervous about it.  I do not believe that it has become larger (and if it has, it has not enlarged much over two years), but now I have begun to wonder if it is cancer.  In fact, I am at the point where I have convinced myself of that fact and I have become very depressed.  I made an appointment with my GP for two weeks from now, but I would really apprecciate it if a Dr. on this board could give me their opinion.  I have seen other postings on various med board where people have described the exact same movable lump (where it could be moved up the other side of the cheek), but the posters never posted their diagnosis.  
Does this sound like a cancerous lesion?  Could it be a cyst or long-infected tissue?  Will a biopsy be necessary.  Please help!
PS-I am a hypochondriac with severe anxiety disorder and this situations is killing me.

[travelgurl222]

A related discussion, Lump below jaw was started.

[herewego071600]

Thanks for your advice!

Turns our the ultrasound showed a 2cm lymph node.  The Dr. said he was pretty sure it was just a chronic reactive lymph node, but said it was worth doing a FNA as a matter of due dilligence.  I had the FNA done three days ago.  The pathology results came back and state that there are no cancer cells and that the lymph node is characteristic of a reactive lymph node! (according to the DR....most likely caused by my chronic teeth problems) Thank God! So, time to move on...finally.

My lymph node is still a bit swollen and sore from my FNA three days ago (my doc moved the needle back an forth a lot to get different types of cells), but it is getting progressively better.

PS
I have noticed that I have a lymph node on the other side of my jaw that I can move around just as easily (ie to the cheek side of my jaw)...but it is smaller and hard to get a grab of.

[Dr. Mike - HHA]

Hi,
I am glad you went and got a 2nd opinion for yourself. It is your body, and peace of mind.
Based on what you stated I do not believe you have anything to worry about. Lymph Nodes can be pushed around, and it may just be part of the submandibular salivary gland -which also can be pushed around...anyway,
At this point I would be interested to hear what your ENT has to say about your Ultrasound, and just be aware of the area and let the ENT know if you ever notice any future changes, and have it looked at at your regularly scheduled physicals / exams.

All the best
DrM
ps- sorry it took me so long to respond I had been checking this forum for about a week or so after I responded and just happened to look again today.

[herewego071600]

OK, so I decided to get a second opinion to be sure.  I made an appointment with a world reknowned ENT doctor that specializes in tumors of the neck and salivary glands.   At first he could not feel the lump, but then I moved it to the outside of my jaw and he could feel it.  He said that it felt like a lymph node that was borderline enlarged and that he would not have noticed it if I did not point it out.   He said that it was probably chronically enlarged because of my bad teeth problems.  He said that there was a slight chance it could be a parotid tumor, but given that the lump had not grown for two years, it was most likely benign if it was a tumor.  Still, he stressed that he believed it to just be an enlarged lymph node.  

So, the ENT Doc. scheduled me for a ultrasound of my neck which I had today.  The technician looked all around and did not find anything suspicious.  All she found was a solitary borderline enlarged lymph node under my jaw.  She said I have a lymph node in the exact same spot on the other side of my that is not enlarged.

So, I am glad to know that it is a lymph node (although no one seems to be able to explain why it migrates so easily)  The results will go to my ENT by Tuesday.  Given the findings as related by the technician, I am not sure if the Dr. will do a FNA.  Either way, I'm feeling a lot better as far as my nerves are concerned.  

[Dr. Mike - HHA]

Simply make sure you express these Specific concerns to your Doctor - (Write them down on paper, and then go back if you feel you need to discuss things again - I rec. In Person, not over the phone)

(BUT, be aware that these visits may not be covered by insurance)

Let her know that you respect her findings, however you will not feel totally comfortable until you and her know definitively what the tissue is...

Hopefully she will simply refer you to another Physician / Specialist if she is unwilling or unable to perform further tests on your behalf.  If not, politley ask for a simple written statement of her findings / exam for yourself and seek a second opinion.

Hope that helps.

M.

[herewego071600]

I went to the Dr. yesterday.  At first she could not feel the lump, but I was able to have her feel it when I moved it to the outside of my jaw.   She said she was 100% confident it was nothing to worry about.  She said nothing that mobile that has not grown for two years could be cancer.  She said it could be a calcification or Lipoma, but she said no tests were necessary.

I am glad that my Dr. believes nothing is wrong.  However, I am a hyperchondriac and I am not wholly comfortable leaving this to chance.  I am considering getting a second opinion/ forcing someone to do a fine needle biopsy and/or an MRI.  What do you think?  

[Dr. Mike - HHA]

Your're Welcome,

If you are able please follow up with your results.

All the Best,

M.

[herewego071600]

Thank you for your advice.  I called my GP and described the lump to her.  She said that it does not seem the least bit malignant and that she is not worried at all.  She said that she does not know of anything that would be so mobile, but she does not think it is anything serious.  She was not going to have me come in, but when I informed her that I already made an appointment with her receptionist, she said that she would take a look at it when I came in.  

[Dr. Mike - HHA]

NOTE: ENT is a Ear Nose and Throat Doctor; and also NOTE: typo correction: otolaryngologist  (a fun one to type fast!)

We usually refer to them as "oto docs"  or "ENTists" for Ear Nose and Throat Docs  -among other names, all slang...  :)

Just checking in to see if you had followed up with your Doctor?

M.

[Dr. Mike - HHA]

Just to 2nd DR. 'Stanford' ,

The right thing to do is to go see your Physician asap. He or she will most likely do an exam / tests / imaging and rec. a biposy of the area, and perhaps a referral if need be to an ENT, and / or Oral Surgeon / DDS. or Otolarygnologist as needed.

Without a full exam and History, and based on your limited description, this "lump" could be several things (to numerous to list all possibilities without seeing you as a patient etc -it may be associated with dental problems or be a medical related problem that is just occuring in the area in conjunction with chronic dental decay); such as:

a Lymph Node - that has hardened from a long standing infection (such as a chronic dental caries, or Bronchitis etc);

a salivary gland 'stone' -although you most likely would notices changes in saliva and size over time as well as discomfort;

Chronic Infection - which is a previous active infection that you body "kind of" walls off and it hardens over time - which could also be the result of a chronic dental caries. etc. Cyst etc.

There are alot more likely possibilities of benign, non cancerous conditions than something cancerous or otherwise,  and a simple exam, history, and most likely radiographs / scans of the area can determine a  Diagnosis, and help rule out other conditions such as Lymphomas, Floor of the Mouth Cancer, Secondary Lesion etc.  

Do not let worry prevent you from seeking a diagnosis (this is exactly why you should go - listen to that little voice), getting one is simple and this will help put your mind at ease knowing what it is, and what you need to do to resolve it.

The fact that it has not grown in size in 2 years or seemed to have changed and that you mention no other issues that you have noticed is a good sign...

All the best, I hope that help you out a bit more.
Thank you for sharing,
Northwestern D.D.S.  - Dr. Mike

ps- please post your Diagnosis when you find out, thank you.

[Denise L. Johnson, M.D.]

You have made a good first step by seeing your physician.  But please know that tooth decay adversely effects your health in many ways.  Long standing bacteria can effect your heart valves and cause infections elsewhere in the body.

In terms of the mass under jaw, a biopsy of the area could be done in the office with a fine needle aspiration.

Take care

[snowtree]

Sorry for the misspelled words= rutine is routine, otolaryngology is the correct name of the doctor, two is to, I am so embarrassed, lol.

[snowtree]

I can't really tell you what it it, all I can tell you is that my 14 year old son has had a little round ball, the size of a bibi gun like on his jaw, the little ball is also movable, and I was very nervous when I felt it, but then I took him for a rutine check-up, and explained it to the doctor, I even told her to touch it, and she didn't even paid attention to it, she touched it and said it was nothing serious, no testing or nothing required.  I myself have like two balls, these are a little bigger, but like they are in both side of the jaw, the same size, but I think they are so weird, and my husband tells me that it is the shape of my face, since I have gained some weight, well I don't think so, but I've had them for a long while, like three years, and nothing has happened, nor have I gone to the doctor for it.  Another thing that I have is a ball the size of a bibi gun also inside the left side of my nose, almost closing the passage that goes inside, I thought I had cancer when I first saw it, and spent all night long looking at it, next day I went to the ER thinking that it was something bad, that was 3 years ago, they sent me to a otolarangologist, (don't know if I spelled it right) and he told me that if it doesn't bother me to breathe that it doesn't need to come out, only if I wanted two, well three years later, I went to another of the same doctor and he told me the same thing, the ball is still there, I am a mouth breather, so it doesn't bother me.  But I suggest that you go to a doctor, maybe you can go to a otolarangologist also, because they are ear, throat, and nose doctors, in other words he could check your jaw I suppose, and you can stop worrying, because worrying doesn't solve any problems, to the contrary it gives you problems.  Go, just so you be calm.  God Bless.