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Child had dental work done and lump appeared on cheek. Hurts to press. Lymph node?

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My 7 year old son has a lump in his lower left cheek near the lower jaw line (but just above it). It seems to have appeared overnight. It is small marble sized (or a bit smaller) and movable and seems firm to the touch. It is not bothering him. He says it hurts only if you press it hard. He had a dental cleaning last week (a week before we noticed the lump). He is seems well he has had a few sneezes and coughs in the last week but nothing really. I am worried and have taken him to the doctor where we saw a nurse practitioner. She did a swab for strep (but he has no real strep symptoms). No results back yet. I also asked for a blood test. He does have a platelet function defect and history of cleft lip and palate. I am worried about this lump, could it be a lymph node? If so should he be on antibiotics? When should I expect it to go down? Does it need an ultrasound or biopsy?

Posted Wed, 6 Mar 2013 in General Health
Answered by Dr. A.K. Srivastava 1 hour later

Welcome in H.C.M.for consulting.

I thoroughly read your complaints regarding a small node on left cheek near lower jaw line. Your son had some dental work about a week back. As you said this lump is freely mobile and pain is felt only on pressing it.

Considering your complaints in all aspects I am suspecting this lump may be-
(1) Enlarge Lymph Node.
(2) Sialoadenoma from parotid.

The higher possibility is of an enlarged node due to the dental work done recently. But since he is not having pain unless pressed, it does not seem to have inflamed. Just that it is active. If there is no inflammation, an antibiotic is not a necessity.

To find out the reality, two basic investigations are helpful in the diagnosis of this lump-
(1) FNAC from lump.
(2) Ultrasonography of parotid area left side.- this test will tell about
attachment of this lump with parotid or it is a lymph node.

By this much work we can tell weather it is a lymph node or adenoma arising from parotid. FNAC will tell about pathological nature of lump.

Hope your query is explained .

With Regards.
Above answer was peer-reviewed by
Follow-up: Child had dental work done and lump appeared on cheek. Hurts to press. Lymph node? 17 hours later
We went to view the results of the blood test and step swab and the blood test was normal (white blood cells were normal as well). The step test was negative so the doctor said it is not bacterial.

He still has the lump, the doctor felt his lump and she said he has another one that is smaller on the right side so that it is symmetrical just that one appears enlarged.

I am hoping that means it is just the lymph node swollen from a viral infection and that it will go away.

How long do you think it would take to shrink to normal size. The doctor said it was about 1 cm.

We also got an ultra sound scheduled for next Wednesday the doctor said she thinks it is the lymph node but I want to be sure.
What are they going to look for in the ultra sound?
What is a Sialoadenoma from parotid?

Thanks for your help,
Answered by Dr. A.K. Srivastava 5 hours later

Thanks for re consulting H.C.M.

I read your query and would like to tell you about some thing about possibilities of different lumps in the area near lower jaw line on left cheek.
(1) Lymph node - lymph node lump is usually mobile, tender in acute phase while in chronic lymph node lump usually no pain or tenderness is found.
(2) Parotid gland is a salivary gland and it is confined to area anterior to the ear and it's lower end reaches up to line of lower jaw. some times lobulated lump arises from it. these are called as adenoma.
You asked about importance of ultrasonography for this lumph,so here I am telling you about what information we get from ultrasound-
(1) What the lump is- Ultrasound will disclose weather it is lymph node or something else, if it is lymph node than what is inside as normal or caseating or necrotic etc.
(2) Ultrasound will tells us about vascularity of lump.
(3) It gives us idea about nearby structures.
Thus if get the reports of ultrasound and FNAC your all query will be automatically explained.

With Regards.
Above answer was peer-reviewed by
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