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Old 09-07-2006, 09:26 AM   #1
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Lump in my childs cheek - a malformation.

Hi - My child was being treated for a sinus infection with antiobiotics about 1 month ago. The Amocycillian seemed to work and things were fine. Then about a week later things seem to flare up again. This time a little swelling in his right cheek. We took him in again, and doc put him on stronger antibiotics figuring the first didn't kill the entire infection (this time Augmentine). He was on for 5 days and the swelling wasn't going away in his cheek. I called the doc and we made an appt to look again thinking it was sinus swelling. She examined him and felt the swelling was in his soft tissue, not the sinus. She pulled up his lip and on the side where the swelling was we noticed a blueish lump which resemebled a vein popping out. She sent us to the hospital for a cat scan. Teh Cat scan of the sinuses was perfect. They did another facial catscan with contrast which showed a mass. Then, sent us to the childrens hospital to an ear nose and throat specialist. They said it seems to be a lymphatic malformation or a vascular malformation of some sort and that it should be surgically removed. But, prior to doing that they want to do an MRI to get more characteristics. I am so scared that this can be cancer of some sort. My child is only 6 years old. The doc said it is highly unlikely that it is milignant and sometimes these things are present at birth and infections sometimes will flare them up. It seems to be puffier in the morning when he wakes up from laying flat all night. Or when he is playing really hard outside. He has no discomfort there, has a good appetite, and is his same exciting self. Has anyone heard of these vasular or lyphmatic malformations in children? Anything you can share? Also, he is petrified to get the MRI done. We are requesting sedation for him, because we know he will not sit still. If he doens't sit still the doc said you have to keep going until you get good pictures. I hope we are going the right route with the sedation....... Thanks for listening. Worried Mother..

 
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Old 09-07-2006, 11:04 AM   #2
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Re: Lump in my childs cheek - a malformation.

I will not name names, but I know of a child that had something similar, but in the throat between the esphogus and vocal cords... a bad location causing respiratory stricture and distress. The child has had eight surgeries and is now one and a half years old with 20% air way restriction due to the remaining mass. The need for multiple surgeries came from the location and the childs age. They could only remove a little at a time and suppress the growth with steriods. It was a rough time, but the child is doing well and the progress looks to be great. If this is the same thing with your childs mass the location makes it favorable for a quick one shot procedure. The fact your child is six also means the mass has more than likely stopped growing, and in fact may be shrinking.

MRI I my 3 year old had one done and was a good trooper. Explain that it is just a very big and fancy digital camera that allows for coll pictures of the inside of his head. He will be able to see his brain and skull with out any pain. He just needs to be very still and enjoy the ride. He can close his eyes and pretend he is somewhere else... a space capsule maybe. If you are lucky it will be a newer MRI with an open rotating ring panel, this makes them feel more relaxed and less closterphobic(sp). It will be over in 3 - 5 minutes. You will be allowed to stand right be side him and hold his hand. MRI's are nothing to be scared of... and see if the technician might get permission for him to watch it performed on another patient.

The mass of the child I speak of was best described as a vascular tumor... it was none malignant and is common in many children...yes many. What made the child in question's case rare, is that it was internal in location. You have probably seen many children with them and just didn't make the correlation. Layman's term for these surface tumors are strawberries. The big red masses seen on the faces and necks of young children. These masses tend to grow until the child is 2-3 years of age... then they convert to a second stage and shrink into moles, which can then be removed via a quick outpatient procedure.

Best wishes to you and yours, stay calm and love your son to distraction.
Respectfully yours,
MG

Last edited by mkgbrook; 09-07-2006 at 11:10 AM.

 
Old 09-07-2006, 12:10 PM   #3
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Re: Lump in my childs cheek - a malformation.

Thank you for the reply. The only thing we can see is swelling to my sons right cheek. Things seem to be going on internally that we can't see, in the soft tissue area, so he has no red bumps, or birth type marks at all on the outside of his cheek. From what the ENT doc said was to remove it they would go inside the mouth through the cheek. NOt from the outside.

Thank you for the encouraging words on the MRI as well. He did fine with the 2 cat scans. The MRI he will be using is not a new one. It's the capsule type. He's nervouse because he remembers when I had one done and said I would never do it again because I was claustaphobic. Kid's remember EVERYTHING. Maybe if my husband and I are in there with him it will make a difference.

Do you know why they would do and MRI if they've already done catscans? I recall the doc saying she wanted to do an MRI before they would do surgery. Something about characteristics of the mass.

Thank you.

 
Old 09-07-2006, 12:54 PM   #4
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Re: Lump in my childs cheek - a malformation.

Yes. I understood that your son has an internal mass, as my niece did. If it is a vascular mass, then it is a tight bunch of capillaries that are growing in a cluster and expand and change as your childs grow. Environmental and internal system changes can inflame and cause changes in the mass.... as indicated by your doctor. The mass growth period normally stops around the age range of 2-3, but the mass can change if irritated.

Most of these vascular tumers are external and while looking bad initially, will eventually shrink and be gone between the ages of 8-10. In the case of the internal ones.. they grow like the external ones but internally. The placement of these can often cause problems if located in the neck.... constricting the air way, inhibiting breathing and eating. Luckily your sons is in his cheak and can be removed with out leaving external scaring.

To answer your question about MRI versus CT scan, the MRI is a more detailed and resolution technique, and will allow for a refined image of your son's mass. I have provided extensive definition and operational procedures below.

Respectfully Yours,
MG

By definition an MRI stands for magnetic resonance imaging and is:

A chest MRI uses powerful magnets and radio waves to construct pictures of the body.

Unlike conventional radiography and Computed Tomographic (CT) imaging, which make use of potentially harmful radiation (X-rays) that pass through a patient to generate images, magnetic resonance imaging (MRI) is based on the magnetic properties of atoms.

A powerful magnet generates a magnetic field roughly 10,000 times stronger than the Earth's. A very small percentage of hydrogen atoms within the body will align with this field. Radio wave pulses are broadcast towards the aligned hydrogen atoms in tissues of interest, returning a signal of their own. The subtle differing characteristics of that signal from different tissues enables MRI to differentiate between various organs, and potentially, provide contrast between benign and malignant tissue.

Any imaging plane, or "slice", can be projected, and then stored in a computer or printed on film. MRI can easily be performed through clothing and bones, however, certain types of metal in or around the area of interest can cause significant errors in the reconstructed images.

Why is the Test Performed?

An MRI provides detailed pictures of tissues within the chest cavity, without obstruction by overlying bone. It may be used to:

1. Clarify findings from previous X-rays or CT scans.
2. Show the structures of the chest from multiple planes.
3. Help diagnose abnormal growths and provide information for the staging (such as the size, extent, and spread) of tumors in the chest cavity.
4. MRI can distinguish tumors or other lesions from normal tissues.
5. Show lymph nodes and blood vessels
6. Evaluate blood flow.
7. Avoid the dangers of angiography or of repeated exposure to radiation.

By definition a CT Scan or CAT Scan is:

(Computer Axial Tomography) A series of X-rays that show the human body in slices. The X-ray mechanism, which surrounds the body, "inches" its way along the area being examined, taking multiple tomograms (slices). The computer is used to turn the tomograms into pictures.

CT scan allow the construction of detailed images and offer another, and in many cases, more affordable means of diagnosis without invasive surgical procedures. CT scans can also be used to guide the course of surgical procedures.

CT scans often utilize a medium or contrast enhancer, provided in the form of a drinkable liquid or via injection into the patient's bloodstream. Approximately 45 minutes before a patient is examined, the individual is given an intravenous injection of a radiopharmaceutical tracer. A brain scan and scan of the spinal cord can take less than 30 minutes.

Radiation exposure from a CT exam is roughly equal to a normal year's worth of exposure to natural background radiation—more than from a conventional x-ray examination, but less than that of other x-ray exams such as a skull x ray.

So in short the doctor wants to get a better thorough look at the mass without exposing your son to more radiation than necessary.

Hope this helps. I check in and offer what help I can.
MG

 
Old 09-08-2006, 06:52 AM   #5
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Re: Lump in my childs cheek - a malformation.

Thank you so much for sharing your knowledge. I'm beginning to feel a little more comfortable with what is happening as I learn more. We go for the MRI next Thursday. Wish us luck. Thanks again ! !

 
Old 09-08-2006, 07:15 AM   #6
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Re: Lump in my childs cheek - a malformation.

Good Luck! Check and see about the previewing. It might also help if he sees you or your husband take a ride in or back out with out the scan. The techs will want to make it as comfortable as possible for your son... let them know of the fear and I am sure they will have a few tricks to help. If your son has a favorite non-metal toy or blanket, it would probably be allowed to go in with him. My sons tech offered to allow stuffed animals and/or a blanket. My sons favorit toys are cars... small metallic... anyway he did fine with out.

It will all work out for the best.
Sincerely,
MG

 
Old 05-17-2008, 08:48 PM   #7
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Re: Lump in my childs cheek - a malformation.

I can totally relate to what you are going through! I have a two year old boy who was born with a lymphatic malformation (vascular anomaly) in his left cheek. He does not have a "strawberry" like most people first believe.

At first my husband and I were told that it was a hemangioma. When we took him to a children's hospital we found out different. Unfortunately for my little boy his first two surgeries were done on the outside which has left his face scarred. His third surgery (his surgeon is an ENT dr also) is set for October and they will be using an internal approach. We will also be planning a face lift for him as his mass is quite large and weighs down the left side of his face. I'm not sure exactly how symmetrical they will be able to construct his face.


While it has been difficult dealing with people and their ugly looks and rotten comments I am trying my best not to lower myself to their level. To me, he is the cutest kid I've ever seen with the best disposition a mother could ask for and in the end that's all that really matters! It is difficult not to be over protective of him though. No mother wants to see their child hurt...that's what mothers do...we protect our young.

On that note, I hope to hear back from you as I feel we have something in common and maybe we could help each other through rough times. If you have any advice for me, I'd surely appreciate hearing it. Take Care!!

 
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