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Consult general surgeon for physical examination,
Multiple causes,
Lumps of less than three weeks' duration are most likely due to self limiting
infection and do not require further investigation but keep under close weekly or fortnightly review. Consider referral if persisting for longer than four weeks.
Examination should be carried out with the patient sitting on a chair; carefully examine the whole of the
scalp, the back of the neck and behind and within the ears.
Establish how deep the lump is: is it intradermal (suggesting sebaceous cyst with a central punctum, or a
lipoma Is the lump in the midline and does it move on swallowing and/or on protruding the tongue?
Palpate the
lymph nodes of the head and neck: are they tender, fibrous, hard or rubbery, fixed or mobile? For submandibular lumps, examine the mouth and salivary glands, looking for oral malignancies or sources of infection, eg abscesses:
If
parotid disease is suspected, identify the orifice of parotid duct and palpate with the patient's head tilted backwards.
Examine the patient's tongue and floor of mouth, with their tongue first protruding and then elevated inside the mouth.
Bimanually, palpate lumps in the floor of the mouth, submandibular area and cheeks.
For lumps in the parotid region, test, assess and record the integrity of the
facial nerve.
get F N A C (fine needle aspiration cytology ) & or excisenal
biopsy,
Treatment depend on cause,
Take care.