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- Sun Jan 08, 2006 7:12 am
I am a heart transplant patient out 8 years. Two years ago I noticed a growth on my left eyeball. Next to the pupil. Turned out to be Squamos Cell Carcinoma. It was removed. Last Aug. I finally went to see a surgeon for what I thought was a hemmoroid. I waited about a year to see him because I was embarassed. Plus ...as a transplant patient I've seen to much hospital as it is. When the pain got so bad I couldn't take it anymore I went to see surgeon. When he looked at it he said it was a wart. (Common among transplant patients.) He removed the wart and sent it to biospy. After the surgery he said he was sure it was nothing to worry about. Well, he called me in a week and said I needed to go back to surgery to have more tissue removed because it was "invasive squamos cell carcinoma." This time he removed A LOT of tissue. Again I'm told everything is ok. Now....I noticed a lump in my lymph node behind my jaw bone under my ear lobe. I have read a lot of online reports about lumps in glands and swollen glands. These all seem small compaired to mine. I can "grab" mine and it feels a little smaller than a golf ball. Its shaped like an egg. It feels hard but not rock hard. I can move it if I move everything it seems to be connected to. There is no pain. For the last 4 or 5 weeks I have been a little short of breath and have had a slight cough. I have also had a hard time sleeping. What do you think? When people have "swollen" glands - how big is swollen? By the way.....one year after TX I had a bad case of Humoral Rejection and was treated with TLI. (Total lymph Irradiation) in very large doses for 3 months. It worked but the doctors told me I could never have radiation again. I'm a "healthy" 52 year old male.
| Dr. A. De la Guerra
- Tue Jan 24, 2006 11:14 pm
Sorry I have not been able to respond earlier. Even though the only way to be sure of the nature of your tumor is to have it in front and examine it properly, I will try to help you based just on the information I have. Behind the jaw bone (retromandibular) and under the earlobe there are many structures (skin, bone, nerves, lymph nodes, the parotid salivary gland, etc). A bump can develop from any of those structures, and could be of benign or malignant nature. From your description of the tumor, it appears to me it could be either an enlarged lymph node or a parotid salivary gland tumor.
As you may have read online, the most common cause of bumps or swollen lymph nodes in the neck are infections. But, when an adult presents a lateral neck mass, in the absence of obvious signs of infection, it is deemed to be cancer until proved otherwise (75% of lateral neck masses in adults over 40 yo are malignant). However, no symptom or complex of symptoms is strongly correlated with cancer.
About your question on how big is swollen, cervical lymph nodes larger than 1 cm. should be considered abnormal. Therefore, a node a little smaller than a golf ball is like 4 cms in diameter, and calls for further investigation. Additionally, it is well documented that solid organ transplantation with its inherent immunosuppression is complicated by an increased incidence of malignancy, particularly cancers of the lymph nodes (lymphomas); and radiotherapy increases cancer risk. As well, retromandibular lymph nodes can directly mirror squamous cell carcinomas of the pharynx, larynx, tonsils, tongue, and tumors of the parotid gland.
Almost 80% of all salivary gland tumors occur in the parotid, and 75% of them are benign. The most common type is the benign pleomorphic adenoma, usually a slow-growing, painless lump at the back of the jaw, just below the earlobe. These tumors are more frequent in people exposed to radiation. Besides, if someone has had radiation treatment to the head and neck area for other medical reasons, the risk of salivary gland cancer increases.
My intention is not to scare you, but due to your past medical history of total lymph irradiation, immunosuppressive treatment, and squamous cell carcinoma arising in two different sites, I strongly encourage you to seek for medical attention.