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Have Long-standing Movable Lump Along Jaw Line. What Could It Be?

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Posted on Wed, 16 Oct 2013
Question: Hi I am a 19yo male with a long-standing(3years) lump along my jawline that is somewhat moveable has not grown in said time and is painless. My dentist didn't think much of it and wasnt exactly sure/ not to worried about it. I was wondering if you have any input?
doctor
Answered by Dr. Sriram Nathan (16 minutes later)
Brief Answer:
Nothing to worry about...

Detailed Answer:
Hello and welcome to XXXXXXX

I am Dr Sriram Nathan, an ENT consultant and I will try to clear your doubts.

At the offset let me assure you that since the problem which you have seems to be benign and not much to worry about. This is because it points to either an enlargement of parotid or lymph node both of which are benign in the background of not growing in size for three years.

Also since you did not mention any other problem such as weakness of the jaw or face, I am more confident that the swelling is benign.

Having said these, I would be very confident and more relieved if we can get to know the nature of the swelling.

For this I would advice you to undergo two simple tests:

1. FNAC or fine needle aspiration cytology; in this a small needle is placed in the swelling and the resultant fluid is analyzed. It is a non invasive test and very sensitive in diagnosing the nature of swelling
2. CT of the Jaw and neck will delineate the swelling and will give us more clues to the same

Get the above two tests done whenever you get the time and get back to me with the reports.

Hope you are clear on the next course of action and I will be more than happy to clear any more doubts that you may have

take care and get well soon

regards

Dr Sriram Nathan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sriram Nathan (13 minutes later)
Okay thanks for your input! My father is a radiologist and feels that it isn't anything to worry about. The only thing that makes me worry is that I use to use smokeless tobacco in that area but have stopped using in that area since discovering the mass and also using in general in the last few months! I agree that the time period with no change in the size of the mass(bb size) and no change in the surrounding tissue according to my dentist. I understand that most "bad masses" have ulcerated tissue surrounding them. Is there any chance that the irritant (smokeless tobacco) could have been the initial cause of the lymph node irritation or the enlargement of the gland? Could this have resulted from trauma associated with the suction put on the area while using chew?
Thanks again,
XXXXX
doctor
Answered by Dr. Sriram Nathan (18 minutes later)
Brief Answer:
Good inputs

Detailed Answer:
Hello XXXXX,

Let me tell you thats its nice to see that you are well informed on some aspects of the nature of mass.

As you rightly pointed out bad masses may have ulcerated tissue surrounding them and they do grow in size. But you must also understand that some bad masses may not have these obvious features and they may appear benign and may not grow in size for years together only to have a sudden growth spurt.

Of course these masses and behavior is rare but you should never take a chance. The tests I have mentioned before will certainly put our mind at ease and then we need to just wait and watch for the swelling.

I would thus urge you to get the tests done to be hundred percent confident and be on the safer side.

About the smokeless tobacco, there have been so many conflicting studies none of which are definite which can pin point a relation. But in your case since you have stopped it completely, you have nothing to worry about. In any case, our tests will confirm any relation according to the result obtained.

Also since you rightly opined, a trauma associated with suction can very well cause the swelling, but even in this case the swelling should have receded and not stayed for so long. Eventually like I mentioned before, the FNAC will help us in further concreting our diagnosis and giving you proper answers.

Meanwhile take the test and get back to me and also hydrate yourself very well and drink plenty of water.

hope your doubts are little more clearer

regards

Dr Sriram Nathan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sriram Nathan (10 minutes later)
Thanks again!
Just a few last questions,
Who could do the FNAC? An oral surgeon? I would feel most comfortable doing it with him if he is able to as he did the implant for my crown due to an impacted tooth. Also what would be a sign that the mass is becoming worse or isn't benign? Growth? Also I fully understand that this wouldn't be a definitive diagnosis nor can a perfectly accurate one be made over the internet but in your professional opinion what do you feel the chances are of this being a benign lymph node, neoplasm, salivary gland obstruction, salivary gland mass etc. I know that the test will be a better answer but just for a little assurance and peace of mind what do you think the probability of the mass being benign is considering all factors.
Thanks again and I will keep you updated!
doctor
Answered by Dr. Sriram Nathan (10 minutes later)
Brief Answer:
Pathologist

Detailed Answer:
Hello XXXXX,

I do understand your apprehensions about the test and the nature of the mass but in my experience it seems to be a parotid gland enlargement which is the commonest in that area and is benign in more than ninety percent of the cases.

In the background of the long term swelling I would assume it to be a pleomorphic adenoma of the parotid gland. Of course it can be confirmed only by FNAC and this is only my opinion after examining more than three thousand patients with similar swellings!

The signs that the mass is becoming worse or unsafe include:
- Sudden increase in size
- Sudden increase in shape
- Sudden pain in and around the swelling
- Weight loss
- Weakness of the facial muscles in the side of the lump such as deviation of the jaw or inability to close eyes etc
- difficulty in opening of the mouth or jaw

these are a few indications though none of them are definite. Also you must remember that you must not wait for these signs to appear to seek treatment.

Also remember that FNAC does not require any hospitalization and is not very painful so you do not have to worry about. Also the results are very valuable and sensitive so go for it!

Finally whoever does the FNAC, the final analysis will be done only by a pathologist so I would advice you to consult a pathologist to perform both.

take care and get back to me with the reports

Regards

Dr Sriram Nathan
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sriram Nathan

ENT Specialist

Practicing since :1996

Answered : 1028 Questions

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Have Long-standing Movable Lump Along Jaw Line. What Could It Be?

Brief Answer:
Nothing to worry about...

Detailed Answer:
Hello and welcome to XXXXXXX

I am Dr Sriram Nathan, an ENT consultant and I will try to clear your doubts.

At the offset let me assure you that since the problem which you have seems to be benign and not much to worry about. This is because it points to either an enlargement of parotid or lymph node both of which are benign in the background of not growing in size for three years.

Also since you did not mention any other problem such as weakness of the jaw or face, I am more confident that the swelling is benign.

Having said these, I would be very confident and more relieved if we can get to know the nature of the swelling.

For this I would advice you to undergo two simple tests:

1. FNAC or fine needle aspiration cytology; in this a small needle is placed in the swelling and the resultant fluid is analyzed. It is a non invasive test and very sensitive in diagnosing the nature of swelling
2. CT of the Jaw and neck will delineate the swelling and will give us more clues to the same

Get the above two tests done whenever you get the time and get back to me with the reports.

Hope you are clear on the next course of action and I will be more than happy to clear any more doubts that you may have

take care and get well soon

regards

Dr Sriram Nathan