What Does A Lump On Right Side Neck Indicate?

Posted on Wed, 28 May 2014

Question: Patient has lump on her right side neck please see MRI report. She is extremely worried.
Age : 34 lives in Egypt, was diagnosed with lumpus when she was 15 yrs used to take 10 mg hostacortin H (prednisolone) daily when a doctor replaced with dexamethasone 15 mg daily 3 months ago. The lump appeared 2 and half months ago gradually became large, hard, not painful and not movable.
Patient went back to take hostacortin 15 mg
Patient has 3 healthy children, still breast feeding 13 months old baby, blood test normal.
Patient is taking antibiotic 2000 cefotax injection daily.
No other symptoms. Does she need a biopsy ? Could it be the change of cortisone ? Does she have to stop breast feeding ? Which specialist do you recommend she has to see ? Please check MRI detailed report and give us your opinion. Many thanks

Answered by Dr. Ashish Verma (5 hours later)

Brief Answer:
looks like submandibular gland tumour

Detailed Answer:
Hi XXXXXXX

Thanks for writing to HCM.

The symptoms and mri findings are suggestive of a submandibular gland tumor.

Hard, painless and immobile lumps are indicating towards malignant nature. Also mri shows loss of fat planes and increased contrast enhancement, which also concerning. I would suggest that you show her to a general surgeon for a clinical examination and a biopsy, and if the biopsy comes as benign, he can excise the lump.

I don't think cortisone have anything to do with this lump. Please go ahead with the biopsy.

If the biopsy comes as malignant, you need to take her to a head and neck oncosurgeon for its excision, as its still very much removable, as its not involving any vital structures.

Hope i have been helpful.

Regards
Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (5 hours later)

Thx for your reply, her doctor suggested swelling due to infection and inflammation
If it's the case antibiotics should do the job ? Also she is breastfeeding does she have to stop now ? Will affect her glands ? Which way is the best ? Thank you

Answered by Dr. Ashish Verma (1 hour later)

Brief Answer:
it should

Detailed Answer:
Hi,

If its infection, then it should respond to antibiotics, but if pain increases even with antibiotics then it may be due to pus formation inside. Then it will need incision and drainage.

Certain groups of antibiotics can be given during breastfeeding, without any harm to the baby, like cephaloaposins and penicillin group and metronidazole group.

I believe your doctor must have already prescribed her antibiotics and painkillers when she had gone to show her. Continue them.

And these drugs don't affect the glands. So don't worry about that.

Regards
Dr. Ashish Verma

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