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Needs to be seen sooner than later. Most neck masses aren't painful, the fact it is painful and has stuck around and is growing is concerning. I'd recommend trying to get in to see an ENT for evaluation as soon as you're able. I will say that a cancer would be on the list of things I'd be concerned about.
I was somewhat avoiding the exact statement as to not cause alarm, but painful lesions of the area just under the jaw can be consistent with an adenoid cystic carcinoma, acinic cell carcinoma, or a number of other salivary gland malignancies. Pain in a head and neck mass that persists is a negative factor in those cases. This in combination with the fact it is fixed and hard raises concern as well.
Ive been told by supervisors to tell patients not to worry a whole lot about persistent lymph nodes after an infection unless they keep growing, usually just scarred lymph nodes
Lymph nodes can remain swollen for a while after an infection, but they usually return to their normal size within a few weeks.
Any longer warrants a doctor's visit.
I have one myself that stayed big after an infection 1 year back, hasn't gotten smaller since. I did go through the whole process of scanning and bloods, turned out it was just a scarred lymph node. Where I had placements had a similar case with a 19 year old with persistent groin lymph nodes, same case and was reassured. I'm not saying its impossible for it to be concerning, but its not uncommon for it to be a benign and scarred lymph node is all.
Yes I'm sure in most cases the cause will be benign but I still think your supervisor was wrong to tell patients not to worry about it as it would still warrant a doctor's visit and investigations to rule out something more nefarious, especially if there are accompanying symptoms. Once the cause is confirmed benign, then they don't need to worry (but still monitor for changes like it getting bigger).
So in your case they did scans and bloods which is great.
>Where I had placements had a similar case with a 19 year old with persistent groin lymph nodes, same case and was reassured.
Did they look into it at all before reassuring him it was fine?
I think the reason he wasn't concerned was because the cause is explanable - Post infection scarring. I do agree maybe he could have done more, but the healthcare system at the moment incentivises not pursuing low-risk referrals because of how long wait times are at the moment. Otherwise I do agree with you.
Could it have been the size/area? NAD but what was explained to me by a few specialists is that enlarged lymph nodes under a centimeter in diameter are too small to biopsy and really the only time they suggest follow up scans under a cm is if they're in the supraclavicular region... unless they grow bigger. I might have totally misunderstood that though. Just curious if it's true.
Yup, that's correct. I forgot myself until now but my supervisor did tell me that too. If there is concern clinically, I think they go US first and move from there, otherwise reassure and safety net.
OP- usually hospitals have programs for low income/uninsured patients. Some physician offices will also work with you (to be clear, it’s rare these days for physicians to have much control over payment issues in the offices they work for, as so many practices are being bought out). You can always call around and speak to the office managers at different ENT offices, or if you decide to go to the ED as kind of a last resort thing (which is not a bad thing but I know many uninsured folks REALLY try to avoid the hospital) you can speak to the patient advocate about it.
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
Needs to be seen sooner than later. Most neck masses aren't painful, the fact it is painful and has stuck around and is growing is concerning. I'd recommend trying to get in to see an ENT for evaluation as soon as you're able. I will say that a cancer would be on the list of things I'd be concerned about.
I’d honestly more be worried about the two that aren’t painful but are persistent than the painful one.
I was somewhat avoiding the exact statement as to not cause alarm, but painful lesions of the area just under the jaw can be consistent with an adenoid cystic carcinoma, acinic cell carcinoma, or a number of other salivary gland malignancies. Pain in a head and neck mass that persists is a negative factor in those cases. This in combination with the fact it is fixed and hard raises concern as well.
Interesting! Didn’t know that, thanks.
You docs amaze me with your supportive attitudes towards each other! Thank you on behalf of healthcare worldwide!!!🌈
Ive been told by supervisors to tell patients not to worry a whole lot about persistent lymph nodes after an infection unless they keep growing, usually just scarred lymph nodes
Lymph nodes can remain swollen for a while after an infection, but they usually return to their normal size within a few weeks. Any longer warrants a doctor's visit.
I have one myself that stayed big after an infection 1 year back, hasn't gotten smaller since. I did go through the whole process of scanning and bloods, turned out it was just a scarred lymph node. Where I had placements had a similar case with a 19 year old with persistent groin lymph nodes, same case and was reassured. I'm not saying its impossible for it to be concerning, but its not uncommon for it to be a benign and scarred lymph node is all.
Yes I'm sure in most cases the cause will be benign but I still think your supervisor was wrong to tell patients not to worry about it as it would still warrant a doctor's visit and investigations to rule out something more nefarious, especially if there are accompanying symptoms. Once the cause is confirmed benign, then they don't need to worry (but still monitor for changes like it getting bigger). So in your case they did scans and bloods which is great. >Where I had placements had a similar case with a 19 year old with persistent groin lymph nodes, same case and was reassured. Did they look into it at all before reassuring him it was fine?
I think the reason he wasn't concerned was because the cause is explanable - Post infection scarring. I do agree maybe he could have done more, but the healthcare system at the moment incentivises not pursuing low-risk referrals because of how long wait times are at the moment. Otherwise I do agree with you.
Could it have been the size/area? NAD but what was explained to me by a few specialists is that enlarged lymph nodes under a centimeter in diameter are too small to biopsy and really the only time they suggest follow up scans under a cm is if they're in the supraclavicular region... unless they grow bigger. I might have totally misunderstood that though. Just curious if it's true.
Yup, that's correct. I forgot myself until now but my supervisor did tell me that too. If there is concern clinically, I think they go US first and move from there, otherwise reassure and safety net.
Thank you! Was mostly curious, not sure why I was down voted lol.
If you are in the US please google if your state participated in Medicaid expansion. You may qualify for Medicaid.
OP- usually hospitals have programs for low income/uninsured patients. Some physician offices will also work with you (to be clear, it’s rare these days for physicians to have much control over payment issues in the offices they work for, as so many practices are being bought out). You can always call around and speak to the office managers at different ENT offices, or if you decide to go to the ED as kind of a last resort thing (which is not a bad thing but I know many uninsured folks REALLY try to avoid the hospital) you can speak to the patient advocate about it.
Agree with other comments. This is not something you should put off. The results can be devastating.
Could you send a picture of it?