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Facial swelling and pressure, swollen salivary glands, tests normal, cysts in breasts. Worried about cancer

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General & Family Physician
Practicing since : 2004
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I have been having odd symptoms since Aug. 2011. It started with swelling and pressure on right side of my face, which gradually led to a visit to ER for numbness on the right side of face. They said swollen salivary glands, see ENT. She said I have "extra salivary tissue" which isn't abnormal, and it's infected. Gave me antibiotics twice.

Eventually the pressure went past my neck (down). All on right side, from head to just below right breast. When I press above breast, I can feel pressure up into my head. Sitting puts more pressure there. Sitting and holding my arms basically at breast level makes it intense. Once the pressure starts, it takes a while to abate and often leads to a severe headache.

I have been to ER 4 times...for these symptoms, and others I don't have time to explain here or it would be a book. But basically my huge complaint is pressure in head and neck. The only "bad news" other than the salivary gland infection, was three nodules on my thyroid. But they said MRIs, MRAs, CT Scan (top of head to pelvis), nuclear stress test, blood, and urine work all showed nothing. They keep sending me home and in fact have implied twice that it's stress. I have asked "would these tests have shown if I have cancer or masses" and they have each time said yes. I've ask "what about my lymph nodes" and they have said "they seem fine" (in those MRIs/CTs, etc.).

My brother, the first moment I told him about pressing on my breast and feeling pressure in my neck, said "sounds like lymph fluid issues" (he is a surgical tech). I am starting to get nervous that he is the only one who has an idea about what is really going on.

I plan to tell my primary care doc Monday, but doubt I am getting a visit with her that day, she is popular and always booked. I am terrified I have cancer and all these tests didn't show it. I had surgery Sept 2009 (total hysterctomy). Have had no other surgeries. I can "cause" the pressure at will by simply sitting down and raising my arms to above my breasts.

I just had a mammogram last Thursday. My doctor felt 2 cysts in my breasts, one on each side, but put on the mammogram referral "non-symptomatic" and did not seem worried about the cysts. She seemed more worried about my heart. Turns out it's perfect. I guess my question is, how imperative is it that I move fast? I have gone to the ER three times since Feb. 14 and feel like a kid crying wolf, but this is very very real and instense, though not painful but for headaches.

What do I do? What kind of specialist do I ask my doctor to refer me to? As extra info, my mother had sarcoidosis and my brother and sister have both been told they may have immune issues at one point (brother was lupus, but undiagnosed, symptoms went away on their own).

Any suggestions? Who do I ask for? WHAT do I ask for? Do I go to the ER yet again, or risk more delays by waiting until Monday and asking my primary care? Bluntly, I am terrified. I feel as though my body has been screaming at me that something is wrong, and doctors just aren't finding it.
Posted Tue, 24 Apr 2012 in General Health
Answered by Dr. Sujeet N Charugulla 4 hours later
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

Salivary glands, thyroid, breast have one thing in common - that you have already put forth in the history clearly - Sarcoidosis. Yes, this is a systemic immune disorder that can answer your ongoing symptoms and signs right now.

For, this you will definitely need a good rheumatologist with special interest in immune diseases. (Also an Immunlogist Specialist Physician available at University Medical Centers.) You can contact the nearest University Medical centre at XXXXXXX File all your reports till date, and have a complete review of your systemic body check by the doctor. You might want to ask for specific blood tests namely, Immunoglobulin levels along with antibody tests that might cost over normal investigations. They are highly specific and can guide in ruling out other immune disorders in the course of management.

You should not panic unduly of any cancer that you have still no proof of. If I were you, I would believe my doctor than a brother even if he is an expert in technical aspects of a surgical machine. That's plainly because correlation of findings is more important than what one sees on the reports sometimes. So, relax and take the earliest appointment with the mentioned specialist.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.


Dr Sujeet N Charugulla,MD.
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