neck lump Flashcards
causes
isolated- dental abscess, tonsolitis, oropharyngeal tumour
systemic disease- HIV, lymphoma, sarcoidosis, amyloidosis, TB, RA, Glandular fever, SLE,
differentials
salivary stones malignancy cyst mass chondroma pharyngeal poch pancoast tumour subclavian artery aneurysm
exam and investigations
ent and thyroid exam
FNA biopsy
Ultasound/CXR/CT
manoux test
treatment
surgical excision
what percentage of malignancies are due to partod tumours?
0.4%
rare
what percentage occur in the paratoid gland
80%
causes
pleomorphic adenomas -80% benign
M:F 1:1
30-50s years of age
no true capsule
warthrin tumour
also slow growing with potential to become malignant
50 years plus , men
malignant tumour
facial nerve involvement
slow growing with potential to mets
how do they present
lump in infected gland
pain, trismus and facial palsy–> malignancy
what is trismus
lock jaw
investigations
ct-differentiate between stones, tumour inflamm
mri - sensitive to detecting surrounding tissue involvement
treatment
excision
where do most salivary gland swellings occur?
80% In submandibular gland
can be paratoid
who ?
older adults-usually old and dehydrated
what is it associated with?
inflam of salivary gland -siialadentitis
what do the stones consist of?
calcium phosphate and carbonate
presents?
with pain on eating and drinking
partial obstruction of duct can last mins to hours where complete can present with persistant pain
can be colicky if in duct
diagnostics?
radiograph of subman and paratoid glands
treatment
if in duct removal under general anaesthetic but if in gland usually gland is removed
if paratoid gland does not require removal but can be treated with sialagogues
sialagogues what are they
example
stimulates/increase flow rate of saliva
example–Pilocarpine
