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Painful lump on cheek. Took antibiotic. Swelling increased. Any thoughts?

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Pathologist and Microbiologist
Practicing since : 2006
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My boyfriend has a lump on his cheek approx. An inch and a half below the tear duct. Its painful to touch and was not relieved after a course of antibiotics. Since beginning a steroid regimen yesterday it is visibly swollen and more painful. Not moveable and width of two pencil erasers not feels unequal in size. Any thoughts?
Posted Tue, 7 May 2013 in General Health
 
 
Answered by Dr. Shailja Puri 41 minutes later
Hello,

Thanks for your query.

A lump on the cheek, which is painful to touch, can be due to a number of causes.
Since, the swelling is increasing in size after using steroids; it is advisable to stop the steroids. Moreover, no drug especially steroid should be started without having a clear indication.
You can use an analgesic (painkiller) for the pain.

It is important to know the character of the lesion.
A fine needle aspiration cytology (FNAC) of the lesion is required.
It is an office procedure in which the material in the lesion is aspirated with a thin needle. The pain is minimal. The cells aspirated are stained with suitable stain and examined under the microscope.
Depending on the results of FNAC further work up is planned.
This may be a biopsy, an excision or medication.

I hope I have answered your query.
If you have more concerns, I will be glad to answer, else close the query with a feedback.
Dr Shailja P Wahal
Above answer was peer-reviewed by
 
Follow-up: Painful lump on cheek. Took antibiotic. Swelling increased. Any thoughts? 3 days later
Thank you for your response. If the lump is solid would a needle biopsy still be appropriate?
The doctor is requesting a CT scan but the cost is high and he has a $5000 deductible.
 
 
Answered by Dr. Shailja Puri 4 minutes later
Hello and welcome again,

A FNAC is good initial investigation in any visible lump on the body.
But the examining doctor is at a better position to access the lump and to plan further.
You can always discuss the cost factor with your doctor so that he/she can order some less expensive test.

I hope my answer helps you.

In case you have more concerns, please feel free to write else close the query with feed back.

Thanks
Dr Shailja P Wahal
Above answer was peer-reviewed by
 
Follow-up: Painful lump on cheek. Took antibiotic. Swelling increased. Any thoughts? 6 hours later
Thank you very much. He is returning to his doctor tomorrow morning. I have asked him to bring up this procedure. You've been really helpful
 
 
Answered by Dr. Shailja Puri 6 hours later
You are welcome. I wish your friend good luck during the appointment.

If you have no more questions, please close this discussion and review.

Dr Shailja P Wahal
Above answer was peer-reviewed by
 
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