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Why do i feel a painful mass above Adam's apple?

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ENT Specialist
Practicing since : 2001
Answered : 2291 Questions
Had a mri 6 months back for throat Pain . Nothing was found. Now since 4 week, i have a burning sensation above XXXXXXX apple(feel like some mass is there) and
with no visible sin of sweeling or mass. i have been to an ENT, he felt the neck and did pass camera into my throat and told me that that every thing looks good He thing my pain is caused by GERD and asked me to take NAPROXEN. This work's but with out medication pain is back . So my question is why i feel mass
above XXXXXXX XXXXXXX (which i cannot see or press to feel it).Now a days paying is comming to right side aslo. Do i need to have another MRI . For what duration MRI is good(i.e how frqently symtoms of throat change on mRI).
Posted Sat, 21 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 3 hours later

Thanks for the query

Sensation of swelling or mass over the Adam's XXXXXXX could be either due to GERD or an enlarged thyroid gland. As you are not able to feel the mass, the probability of the mass being mere sensation only could be around 90% and related to GERD itself. If it were to be related to the thyroid gland then you would have felt the mass.

It so happens when the acid comes up in to the throat it burns the throat, because the mucosa of the throat is different compared to that of the stomach. Hence because of this burning sensation there will be swelling inside the throat which gives a sensation of lump in the throat, weakening of the voice after a brief conversation, excessive salivation, etc. Naproxen is a pain reliever which will also reduce the swelling inside the throat but not GERD.

It would be wise if you can get an ultrasound of the neck done so that any mass in the neck region can be ruled out. Secondly, MRI is required to confirm the type of neck mass if anything is detected in the ultrasound only. Finally, things in the body change within hours to weeks and MRI done 6 months back may not be of much importance in your case. If at all you strongly feel there is something which is really bothersome for you, then you can definitely go ahead with a MRI.

As of now, I would advise you to drink plenty of warm water, avoid smoking/alcohol if any and avoid taking Naproxen as much as possible. Continue with Nexium, also discuss with your doctor to add on Domperidone tablet which helps in increasing gastric motility and strengthening of the esophageal sphincter. Ultrasound of the neck will be helpful in providing information about any neck mass.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Why do i feel a painful mass above Adam's apple? 20 hours later
In my last note i forgot to bring it to your attenstion that, i have thyroid issues
and ultra sound was done and identified them as benine adenoma's. Right one is bigger than left one. Still have couple of follow up question's

1) for my pain near by XXXXXXX apple(4 to 5 cm from v shaped XXXXXXX apple), i did visit 2 different ENT doctors 3 times. One even checked with a camera in my throat. So my question is , are they any changes that they can miss some thing which is really wrong.
2) I event went to ER room and she did some blood work to check my white blood cell count and told me normal.
3)I have another app with my ENT on sep 1st. If some thing is wrong , what symptoms do i need to observe during this time.
Answered by Dr. Naveen Kumar 6 hours later
Hello again,

Thanks for writing back.

Here are my opinion about your queries:

1. Are there any changes that they can miss something which is really wrong?

a: The possibilities that a doctor can miss any important finding during an endoscopy is more unlikely as the findings are enhanced on the monitor. Secondly, they can see only the anatomical abnormalities above the mucosa but not below it, a MRI/CT Scan would be more beneficial in that case.

2. Normal WBC count.

a: That rules out lymphomas and other hematological abnormalities. It also rules out active infection.

3. If something is wrong, what symptoms do I need to observe during this time?

a: Along with the present symptoms you are facing, you should also notice for any difficulty in swallowing, change in the voice, breathing difficulty, pain radiating to the ears or to the upper part of the neck.

Apart from these things, even a progressive adenoma of the thyroid can cause symptoms of pain over the anterior part of the neck when they induce pressure over the surrounding structures.

A MRI of the neck can provide a lot of information in this regard and put a stop to all your doubts and apprehension.

One more thing I would like to bring to your notice is a constant palpation of one particular area out of apprehension can become painful which might be mistaken for a pathological condition.

Wish you good health.

Dr. Naveen Kumar N.
Above answer was peer-reviewed by
Follow-up: Why do i feel a painful mass above Adam's apple? 5 days later
Thanks for your reply. I uploaded thyroid ultra sound (done a month back), X-ray of throat and blood work(done 2 weeks back). Do you see any abnormalities in X-ray.Can x-ray really identify any mass in the throat. Currently i am having pain in the throat on both sides( exact location of pain. i see some v shape in throat. My pain is below it 5 cm from the center on to both sides)

If i take ibuprofen, pain goes away for 5 hours and i have to repeat the medication.
Pain is like a burning kind of feeling. I check my throat , but i do not see any swelling .Really worried whats happening. Tomorrow i have an appt with endocrinologist. So what should i have to check with him.As an Indian living in USA,
some times i feel , unable to explain the symptoms correctly.I would have asked for a CT, but really scared of them(Last 6 months had 4 abdominal ct's).I have an appt with my ENT on SEp 1st. I am planning to ask him for a MRI . Please let me know what should i do.

Answered by Dr. Naveen Kumar 5 hours later
Thanks for the follow up.

I have gone through the reports posted by you; it says you have some minor changes in the thyroid gland as well as your spine which are insignificant and not related to your problem.

The fact that the burning sensation is getting relieved with the ibuprofen is because the inflammation is reduced with the medicine. Thus the cause of your problem could be either a mere mucosal inflammation or a sub mucosal soft tissue lesion or rarely a neurological lesion.

X-ray is not useful in diagnosing soft tissue and neural lesions; instead MRI would be a better tool to diagnose the same. And, MRI is always better than CT scan in diagnosing these types of lesions.

As you are visiting an endocrinologist, the doctor might look into problems related to the thyroid and ENT can perform an endoscopy again to look for any changes in the throat and neck.

Also you can request your doctor to get a MRI done so it can put a stop to all your worries. Once you are done with the consultation and investigations please let us know what their findings were.

I hope that you will recover soon with the right treatments.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Why do i feel a painful mass above Adam's apple? 2 days later
Please see attached ultrasound done on 08/24. I am really scared about observation on parathyroid adenoma.

1) Is parathyroid adenoma life threatening or it can be treated by surgery
2) Please provide me some suggestion on this issue.
Answered by Dr. Naveen Kumar 2 hours later
Thanks for the follow up.

I am unable to find the new reports linked to this query, can you repost it or mail it to me, I will be able to help you better after going through the report.

You can mail to YYYY@YYYY Sub:ATTN Dr Naveen Kumar.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Why do i feel a painful mass above Adam's apple? 24 hours later
ultra sound report attached
Answered by Dr. Naveen Kumar 13 hours later

I have gone through the new report; here the radiologist has mentioned that he cannot appreciate any significant changes compared to that of the previous report except for a small swelling, which could be a parathyroid adenoma in the lower pole.

Parathyroid glands are those glands which are responsible for maintaining calcium balance in the body. Increased secretion of the parathormone secreted by these glands can lead to a harmless swelling known as Parathyroid Adenoma. Again, this is just a speculation which has to be confirmed with blood investigations (calcium, phosphorus and bicarbonates) and MRI of the neck.

Individuals with Parathyroid Adenoma will have the following symptoms such as bone fractures, constipation, lethargy, etc. Parathyroid adenoma can be totally removed surgically and the prognosis is very good.

Even if this is confirmed, parathyroid adenoma cannot be the prime cause for burning sensation in the neck. As I have already mentioned above, you can undergo the blood investigations as well as MRI, which can clear off all your doubts. Till then keep yourself relaxed.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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