Lump behind my right ear for a year

[Rubiegem8280]

I have had a lump beihnd my right ear over the edge of the temporal bone for about a year. Recently noticed it is a little larger, and irritating or irritated by my hearing BTE hearing aids. I can not wear headbands, my hearing aid or anything behind my ear because of it. I wanted to have the lump removed. It is about 4cm in diameter, very hard, normally painless, and immobile. A doctor a year ago suggested it was just a cyst and nothing to bother with. I have also been very ill for 3 years without an explination yet. Recently I have developed chills all day, night sweats, and blamed my 27 lb weight loss over the last 2 months on developing ulcerative colitis. I have been having boughts of extreme fatigue to the point of falling asleep mid activity. I have a nuerologic problem with the very start of damage system wide that my neurologist believes is autoimmune. I have had chronic migraines since 14 (28 now), hearing loss over the last 5 years, and severe pain elsewhere. Labs have shows a tendency to elevated WBCs and polyclonal hypergammaglobulinemia. I do get low grade fevers off and on but tend to be a normal 97. I have also had an enlarged mobile lymph node in my left axillary for years that I assumed was irritated from underwire bras or shaving. In addition I have a couple lumps in my left breast being followed, though believed to be benign cystic changes. Should I be having the lump behind my ear investigated? Or is it likely a cyst that would be easily removed?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,

Please get a CT scan of the head/neck region, including bone windows.

Here is some info on osteoms:

Osteomas (benign bone tumors) may be painful, especially at night, and often relieved by aspirin. However, osteomas need not always be painful.

The following extract is taken from bonetumor.org:

Osteomas are slow growing lesions that are normally completely asymptomatic. They only present if their location within the head and neck region is causing problems with breathing, vision, or hearing... Some authors report that osteomas occur more often in women than men (3:1).

Good Luck!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Please read up on Osteomas, which are commonly found on skull bones.
I would also recommend that you get your prolactin levels checked. Also do an imaging (CT scan) of the skull bones and pituitary gland.
Good Luck!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
It is good news that the MRI came back normal.
Please discuss the next diagnostic interventions and treatment options with your doctors.
Good Luck!

[Rubiegem8280]

The MRI came back normal. No adeoma or MS, but did not have bone margins. Not even all fascial bones. Osteopath told me today she does not think that spot is lymph or bone. Still very very ill. At least being treated for the itching now, though no further investigations planned. See an ENT, neuro, and Gi over the next week. I will keep asking questions and see if we get anywhere.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
The symptoms need to be investigated and diagnosed promptly.
Good Luck!

[Rubiegem8280]

Thank you for your patient replies. I have been getting much worse over the last few days, losing another 4 lb and increasing in symptoms. Regardless of the MRI I think I have to follow up on this problem. Again thank you.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Good to hear these reports. Let me know what the MRI shows.
Good Luck!

[Rubiegem8280]

Just heard back from the doctor's office. As I suspected: WBC is 12,500 (has been at least this off and on for a couple years), prolactin was normal.... but she did order the MRI. Waiting for referrals to schedule me. Nothing else of note on the tests.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Good luck with all the reports. I would be interested in knowing the results and your further progress!

[Rubiegem8280]

I guess I am severely frustrated. MY PCP is denying doing a scan. She did test for CBC, WBC with differentials, TSH, Prolactin, Electrolytes, etc... Said she may order an MRI after depending on the results because she feels I may have an adenoma of the pituitary. Which is some ways fits but mostly seems off to me. Though, it makes me mad and concerned why she wouldn't just order the stupid scan. She didn't even seem to listen to me. I mentioned osteomas, I mentioned how I felt I couldn't brush off the lumop as a boney prominence when it was new a year ago and bigger now. Not to mention she kept blaming my hearing aids, which I got after the lump showed up. Its all so maddening! She refused to acknowledge any other symptoms: chills, mild fever off and on about a year, night sweats (which are worse), weight loss suddenly, itching and some sort of immune hyperactivity (though I catch EVERYTHING), severe migraines nearly daily now, just not normal stuff!

Sorry for venting on here.... figured you had read all the rest, would want closure. Not that I even got any. Will hear back on the labs tomorrow I think. Doubt there will be anything to report that I didn't already know.

[Kamal S Saini, MD, MRCP (UK), DM]

Just ask!
A CT will help document the size and shape of even a benign lesion, so will be helpful in any case.
Good luck!

[Rubiegem8280]

Any recommendations on how to ask my primary care doctor for a head CT with bone windows, when she believes the lump is totally benign and not worth looking at? But I am having more problems. Including sudden severe generalized itching lasting 4 days now, though down from the first 20 hrs which was promtly followed by node swelling all right sided and all around my ear, which is still getting larger (esp below the site), with no other signs of infection. (in fact my audiologist checked the next day and said my ears looked great) Is there a way to approach a doctor about a test you feel needs to be done, when they feel it is not necessary? I see her in the morning about the axillary lumps, hormonal issues, and a breast exam. I know she plans on blood work for prolactin, etc... Oh BTW with some of the inflammation down over the original lump (no hearing aids for a while or anything on my head) the actual lump had no regular or well defined margins. It feels kinda like multiple lumps grown together., at least two layers-ish. I think a head CT is a great idea with my migraines, but she isn't into doing tests that other specialists should be doing. And my neuro said she needed to check this issue. Confused a bit!

[Rubiegem8280]

From my understanding (which is limited in this area) an osteoma or osteosarcoma would both be very painful, or at the very least tender. My lump is not either of those things. The only time it hurts is when the skin is irritated and breaks out over it. I had to see my podiatrist the same day and he said that it needed further examination and was an obvious asymmetry in the temporal bone structures if it is bone. I am kind of confused. Can there be a osteoma without pain? Could it feel like bone but be something else? I have also had a severe increase in migraines over the last 4 months, to a nearly daily level. Also problems off and on with blurring vision, vertigo, and what I thought was "fibrofog." (Dxd in 98 with fibromyalgia) My typing and speech seems off to me but has been a while. So that may be why I feel confused. For over a year I have also had episodes of severe parasthesia in my face and arms for days at a time, even sometimes getting carpopedal spasms during the episodes. All of my fibro symptoms seem to be neck and shoulder. I wonder if the lump could be causing nerve entrapment or irritation to the area? I had the prolactin level checked last summer and it was normal, but I also didn't have those issues then, just random leaking periodically.

[Rubiegem8280]

My Primary doctor, a family GP looked at it and said it was a growth of the skull bone, not mobile, very hard on the edge of the temporal bone, nothing that can be removed. It is unilateral and grown over the last few months. I have never heard of something like that before. She is however wanting to re-evaluate the breast issues as it seems something hormonal is happening there. (My daughter is 3 and recently I have been having "let down" and staying engorged for a day or two at a time, not cyclic. I barely produced any milk when she was born!) So I guess I will do some research on this "bone growth" because it is a real problem for me. Thank you for listening and for advice.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
It would be best if you are first evaluated by an internist. He or she would be able to evaluate your condition and the various symptoms in totality. Good Luck!

[Rubiegem8280]

Thank you for responding. I have an appointment with my primary care doctor tomorrow morning, should I ask to be referred to an ENT, Internist, etc? My Primary is a family GP. Should I be concerned about the lump or is it premature to worry at all? A friend recently dx'd with Lymphoma is worried, but I have been putting off checking it for this long....

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Please have a surgeon evaluate the hard, growing, lump behind behind your ear.
About your other conditions, please continue to be under follow-up for the GI and neurological symptoms.
Please post additional questions if you need more specific advise.
All the best, and God Bless!