[32F] Experiencing swollen lymph nodes, neck mass, and menstrual changes

Patient Description

A 32-year-old female presents with swollen lymph nodes on the right side of the neck near the jaw and a noticeable mass at the base of the front of the throat. The mass is described as fixed, not perfectly round, solid but not rock hard, and visible during swallowing. It was first noticed approximately 6 months ago and has slightly increased in size. Additionally, the patient reports significant fatigue, a lack of appetite, and recent changes in her menstrual cycle, with periods lasting 18 days, occurring twice over the last 3 months with approximately two weeks in between. There are no reported changes in weight, voice, or difficulty swallowing, and no history of trauma to the area. The patient experiences shortness of breath more quickly during exercise but no rapid growth of the mass or difficulty breathing. No fever or night sweats have been reported, although the patient does experience brief heat waves. There is no known family history of thyroid problems or hormonal disorders.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Thyroid Nodule: A thyroid nodule is a lump that can develop in your thyroid gland. This gland is located at the base of your neck, just below your Adam's apple. Thyroid nodules are common and usually benign (noncancerous), but a small percentage can contain thyroid cancer.

    • Diagnosis often involves a physical exam, blood tests, thyroid scan, and/or a fine-needle aspiration biopsy.
    • Treatment depends on the type of nodule, and can range from watchful waiting to surgery.
  • Thyroiditis: This is inflammation of the thyroid, which can cause pain and swelling in the neck, fatigue, and changes in menstrual cycle. It can be caused by an autoimmune condition, infection, or certain medications.

    • Diagnosis often involves a physical exam, blood tests, and/or a thyroid scan.
    • Treatment typically involves managing the symptoms and treating the underlying cause.
  • Menstrual Disorders: Changes in menstrual cycle can be caused by a variety of conditions, including hormonal imbalances, fibroids, polyps, or more rarely, cancer.

    • Diagnosis often involves a physical exam, blood tests, and/or imaging studies.
    • Treatment depends on the underlying cause and may include hormonal therapies or surgery.

Please note that these are possibilities based on the information you've provided, and not a definitive diagnosis.

What you can do

Given your symptoms, it's important to seek medical attention. Here's what you can do:

  1. Schedule an appointment with your primary care provider. They can perform a physical examination and order necessary tests to help determine the cause of your symptoms.
  2. Keep a record of your symptoms, including your menstrual cycle, any changes in the mass, and any other symptoms you may experience. This can help your healthcare provider in their evaluation.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

  • Difficulty breathing or swallowing
  • Rapid growth of the mass
  • Severe pain in the neck or mass
  • Significant weight loss without trying
  • Persistent fever or night sweats

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment.

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People Also Ask


What are the common causes of swollen lymph nodes in the neck?

Swollen lymph nodes in the neck can be caused by infections (such as a cold or sore throat), immune system disorders, or, less commonly, cancers. They often swell in response to infection or inflammation in the area.


How can thyroid nodules affect menstrual cycles?

Thyroid nodules can affect menstrual cycles if they alter thyroid hormone levels, leading to hormonal imbalances. This can result in irregular periods, changes in flow, or other menstrual irregularities.


What are the typical symptoms of thyroiditis?

Typical symptoms of thyroiditis include neck pain or swelling, fatigue, changes in menstrual cycle, and sometimes symptoms of hyperthyroidism or hypothyroidism, such as weight changes or temperature sensitivity.


When should I be concerned about a neck mass?

You should be concerned about a neck mass if it grows rapidly, causes difficulty breathing or swallowing, is associated with significant weight loss, or if you experience persistent fever or night sweats. These could be signs of a more serious condition requiring immediate medical attention.


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