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Painless lump under chin, definite shape, rubbery, coldsores. Cancer?

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My healthy and active three year old daughter has two pea sized painless lumps centered directly under her chin. They have been present for about 3-6 months and have not changed in shape or size. The texture is sort of rubbery, not hard and not soft. She currently has a breakout of coldsores, but I do not recall her being sick when I first noticed them. I'm terrified this could be some type of cancer. Her Dr. Has referred her to an ENT Dr but her appointment is not scheduled for another 3 days! I'm so scared!
Posted Sun, 29 Apr 2012 in Cancers in Children
 
 
Answered by Dr. Sumit Bhatti 27 minutes later
Dear XXXXXXX

Thank you for your query.

1. Small, firm, painless lumps under the chin are most likely to be enlarged sub-mental lymph nodes.

2. Sub-mental lymph nodes drain the lower lip, parts of the cheek, central teeth, floor of mouth, sub-mental salivary glands, tip of the tongue and lower central jaw.

3. Any local infection, such as cold sores, causes these glands to react and enlarge.

4. There are normally close to three hundred lymph nodes in the head and neck region of our bodies.

5. Normally, lymph nodes are not palpable, but after reacting to any infection or inflammation, they enlarge and then rarely return to their original size. Thereafter those affected nodes can always be felt as firm , rubbery lumps.

6. Isolated small, recent, painless lumps with no other complaints such as fever, pain, weight loss, fatigue or night sweats, should not be a serious issue.

7. At her age, the above signs and symptoms are unlikely to be cancer in any form.

You may mail the photograph/s (front of neck & neck profile) to YYYY@YYYY with subject: 'ATTN: Dr. Sumit Bhatti'.

If they are increasing in size or number, you should see a General Physician or Dermatologist to start medication which will easily control this condition. Mild infections are self limiting and may not require any treatment. Routine Blood tests, Neck USG (UltraSonoGraphy) and FNAC (Fine Needle Aspiration Cytology) may be done, accordingly, for example to rule out sub-mental salivary gland enlargement.

Anticipating your reply.
Above answer was peer-reviewed by
 
Follow-up: Painless lump under chin, definite shape, rubbery, coldsores. Cancer? 42 minutes later
Thank you for giving me a more positive outlook on her condition. The only other symptom she does have is night sweats. It is not excessive and doesn't happen every night. It seems she has been a warm bodied sleeper since she was a baby. When she does sweat at night, its usually Just her hair that gets damp, not her entire body. I'm not sure if this is what is meant by night sweats. She does NOT show signs of weight loss, loss of appetite, or loss of energy. Some things I've read on the internet have really scared me.
 
 
Answered by Dr. Sumit Bhatti 59 minutes later
I do not think that her sweating is significant. Being warm bodied is a sign of good health for a child. The best way to set your fears at rest is to systematically do the above mentioned examination, investigation and treatment. Then,there will be no doubt.

Wishing you all good health in the future.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Painless lump under chin, definite shape, rubbery, coldsores. Cancer? 7 hours later
Any idea as to why you believe the lumps have been there for so long and why they are not going away even when she is not showing signs of infection?
 
 
Answered by Dr. Sumit Bhatti 24 minutes later
Hi,

Thanks for writing back.

Elaborating Point No. 5. in the explanation above:
Normally, lymph nodes are not palpable, but after reacting to any infection or inflammation, they enlarge (because of hyperplasia of the cortex and lymphoid follicles) and then rarely return to their original size. (even after the original cause has subsided). Thereafter those affected nodes can always be felt as firm, rubbery lumps.

Sub centimeter sized lymph nodes are considered benign and may remain palpable throughout life with no consequence.

Regards.
Above answer was peer-reviewed by
 
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