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Mass on cheek just below cheekbone and CT scan showing lymph node. Having headache and shoulder pain on that side. What is the next step?

Oct 2013
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General & Family Physician
Practicing since : 2011
Answered : 516 Questions
Mass in cheek just below cheekbone. Saw dentist, eye doctor, and ent. Ent tx with bactrim and after that with a round of keflex. 6 weeks later due to same size, sent me for a CT and results are that it's a lymph node. That was 4 days ago. Having headaches, neck, cheek, and shoulder pain all on that side....... What's the next step? How can it reduce and the pain stop?
Posted Sun, 17 Nov 2013 in General Health
Answered by Dr. Namala Bharadwaj 1 hour later
Brief Answer:
FNAC will help in diagnosis.

Detailed Answer:
Hello dear.
Thanks for your query at XXXXXXX
I understand your concern.

Lymph node enlargement is common in cheek and neck region.
Enlargement can be due to infection, inflammation, connective tissue disease or malignancy.

Next step would be to find what has caused the lymph node enlarge because it is not decreasing even after a dose of antibiotics.
Fine needle aspiration cytology (FNAC) can help you in finding cause for the lymph node enlargement.

Pain reduction you can take anti inflammatory drugs like paracetamol or aceclofencac.

Lymph node will automatically decrease in size once the primary cause is treated .

My recommendation would be that you get FNAC done and we can discuss further based on reports.

Hope I answered your query.

Any further information you can ask me in follow up question.
Direct query at
WWW.WWWW.WW Regards.
Above answer was peer-reviewed by
Follow-up: Mass on cheek just below cheekbone and CT scan showing lymph node. Having headache and shoulder pain on that side. What is the next step? 20 hours later
ENT follow-up appt today. ENT set up lymph node excision for next week. He said he's not concerned at all but wants to send whole node to pathology for my peace of mind. He said my CT was unremarkable except for the node. It's 1.1x1.2cm. It's pressing on artery and that could be the reason I'm having pain on that side. CT revealed no infection or inflammation. I understand I can't worry until path report comes back but I am so worried something underlying has caused this enlargement and they haven't found that yet. Due to my Cpap strap, I have pressure near this node day in and day out. Also, I suspect a mold issue in the office I work in. I see housekeeping wiping mold from the outlet recepticals daily; that tells me that company is only putting a bandaid on the mold. I wonder if this node is fighting the mold and this is the reason for enlargement, then continued irritation from Cpap strap. Is total excision warranted? Should I ask for a second opinion or more testing?
Answered by Dr. Namala Bharadwaj 2 hours later
Brief Answer:
FNAC will help before excision.

Detailed Answer:
Hello XXXX.
I understand your concern.

Before going for excision FNAC will provide details of what happened to node.
If FNAC is not conclusive then excision biopsy might be necessary.

Lymph node enlargement can be due to infection as I mentioned earlier.
Pain might be due to strap also.

My recommendation would be discuss with doctor about FNAC before going for excision. If that is inconclusive then you can go for excision.

Above answer was peer-reviewed by
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