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- Wed Jul 20, 2005 1:54 pm
hi. wondering if anyone can offer suggestions. i have a lump (about the size of a fat lima bean) under the left side of my tongue. i have done extensive reading to see if i could have some knowledge on the subject prior to my dr. visit. (which by the way took 1 dr.visit to primary care, given antibiotic, followup 1 wk later - referred to ENT). waited for ENT appt (2 weeks) and could only see the physician's assistant (PA). whew!
i have been told i may have sjrogren's syndrome in the past...
also have salivary gland stones. but i don't think this is a stone, since the stones are extremely painful and this has no pain what-so-ever.
also have been diagnosed with Rheumatoid arthritis.
during my visit, the PA (physician's assistant) said that my sjrogren's syndrome doesn't have anything to do with this problem. when i asked him if it was in the sublingual gland, he said there was no such thing. oh my gosh! i think i should be concerned, however the dr. is great. just don't know when i can see him.
PA ordered a saline test that measures the flow of the saline through the salivary gland to determine whether the lump is in the gland or along side it. while this makes sense, in my reading it says over and over again by many, many sources that the lump should be removed whatever the reason (benign or malignant). it also said that this type of test is very rare for a dr. to order. the articles suggested an MRI and 2nd option as CT scan.
hope i haven't rambled too much, just concerned that i am not being taken seriously - the text goes on and on and on about if lump remains after a month, immediate action needs to be taken... blah blah blah.
i guess my main concern is whether it's in the gland or along side it. and what gland it is actually in. the submandibular gland has a better outcome while the sublingual has more malignancy.
any input? :)
| Dr. Safaa Mahmoud
- Sat Jul 15, 2006 7:41 am
Without clinical examination, it is difficult to tell what this lesion could be.
Tthe best thing to do is to be examined by the NET specialist as soon as possible.
The lump could be of benign cause, like a cyst or or any lesion in the duct of the submandibular salivary gland.
It might be also mucosal changes associted with one of the systemic disease that you have been diagnosed with.
For example, oral Lichen planus which occurs in people having immunologically mediated disorders.
Oral lichen planus (OLP) usually seen as bilateral white striations, papules, or plaques on the buccal mucosa, tongue, or gingivae.
Oral lichenoid lesions similar to OLP which results from drug reactions in patients receiving one of these drugs:NSAIDs, beta-blockers, sulfonylureas, some ACE inhibitors, etc.
Lichenoid lesions of unknown cause are known as idiopathic OLP.
In such cases Dermatological examination is necessary.
At same time exclusion of malignant lesions is important.
The possible investigations to be requested in your case are X-ray, CT , or MRI and biopsy if needed.
Early malignant or premalignat lesions in the oral cavity can be removed surgically with good outcome.
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