So, i have been quite sick for a while and after seeing many specialists, i remain undiagnosed, although all the docs know something is wrong because all my inflammatory markers are high - crp 5.4, sed rate ranges from 30-75, etc. Anyway, i was just sent to an oncologist to see if perhaps she could have some answers. she asked me if i have any lumps, and i pointed to the outside back of my lower jaw... just abive the jawline in front of my ears. after she did an assessment, she decided to send me for an ultrasound saying, "well, that shouldnt be there"... today was my ultrasound. i guided the tech to where i have the bump and she took images in the area and behind the area under my ear. after the images were taken, i was on my way out when the tech came out of the office and told me that they needed me to come back in. they wanted the radiologist to come immediately to look at the films. the radiologist came and took more images. three people were in the room talking while i was there. they found two masses on my left side, none on my right side. the radiologist told me that they look benign. he said they were lymph nodes. he said that he would send his remarks to my oncologist tomorrow. the tech said that he was going to write that there are two lymph nodes that look superficial or something like that.
so, here are my questions:
can an ultrasound really tell if a mass is benign or not?
should i get a second opinion?
anyone have an experience like this and what happemed?
anyone told that a mass looks benign, when in fact it was malignent?
i appreciate any insight i can get!
sorry about typos... doing this on my tablet!
Last edited by TheUndiagnosed; 01-31-2013 at 02:23 PM.
I am concerned that my oncologist just wants to "wait and see" about what happens with the masses. One is just over 1 cm and it is just anterior to the Parotid gland. One is about 8mm and is within the parotid glad. When I read online, they say that even if they are lymph nodes, there should not be masses in that area. Does anyone know if a "wait and see" approach is best or if the masses should be biopsied? From what I have read, even if benign, masses in this area should be removed. However, I would like to know other people's experiences with this issue.
Given the relative small size and the proximity to the parotid gland, I think there is a reasonably good chance these nodes, along with your elevated inflammatory markers, could be caused by Sjogren's syndrome, an autoimmune condition that affects the salivary glands and other glands that produce tears, vaginal secretions, etc. The inflammation can cause the fatigue and malaise. Others signs of Sjogren's are dry eyes, dry mouth, dry vagina, some with it get joint pains. I know you said you were checked for AI disorders, but blood tests for Sjogren's (SSA, SSB) are not often done, and they are negative in as many as 40% of those with it. I would ask that at least those blood tests be done, and consider seeing an ENT who might be able to rule parotid gland inflammation out with something else like a sialangiogram. Tenderness, heat and swelling of the gland (like in mumps) would also be signs of inflammation. Sjogren's can be diagnosed as well with a lip biopsy. If any of this fits with your picture, a short course of Prednisone (2-3 months) may be all that is needed to get the nodes to resolve. If the node does get biopsies, perhaps a needle biopsy from inside the mouth could be done to avoid incision on the face. I don't favor a wait and see approach, because you are ill and anxious and need some answers.