[42F] With a hard lump under the chin and episodes of flushing

Patient Description

A 42-year-old female presents with a hard, immovable lump under the chin, which has increased in size over the last few days. The area around the lump is tender, but the lump itself is not warm or red and does not cause pain. The patient also reports fatigue and multiple daily episodes of facial and neck flushing without associated alcohol intake, which is a new occurrence. She sometimes experiences difficulty speaking. The patient has a history of anemia diagnosed in 1999 and has had shortness of breath for the past two years. She is currently taking Ibuprofen 200mg twice daily. There is a family history of lung and breast cancer, but the patient is unsure of the age at diagnosis. No known allergies or other medications, vitamins, or supplements are reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Lymphadenopathy: This is a condition where the lymph nodes become enlarged. Lymph nodes are small, bean-shaped glands that produce and store cells that fight infection and disease. They are part of the body's lymphatic system. The lymph nodes under the chin and in the neck are often the first to swell when the body is fighting off an infection or disease. The lump you're experiencing under your chin could be an enlarged lymph node.

    • Treatment: The treatment for lymphadenopathy depends on the cause. If it's due to an infection, antibiotics or antiviral medications may be prescribed. If it's due to an immune disorder or cancer, other treatments may be necessary.
  • Salivary Gland Disorders: Your salivary glands produce saliva, which keeps your mouth moist and helps you to digest food. There are three pairs of major salivary glands. The submandibular glands are on the floor of the mouth, and can sometimes become blocked or infected, leading to a lump under the chin.

    • Treatment: Treatment depends on the specific disorder, but can include medications, warm compresses, and in some cases, surgery.
  • Thyroid Nodule: A thyroid nodule is a lump in or on the thyroid gland. Thyroid nodules are common and usually benign (noncancerous), but a small percentage can contain thyroid cancer.

    • Treatment: Treatment depends on the type of nodule. If it's benign, it may not need treatment. If it's cancerous, treatment options include surgery, radioactive iodine, hormone therapy, or chemotherapy.
  • Carcinoid Syndrome: This is a group of symptoms that some people with carcinoid tumors experience. These tumors are rare, and they occur most commonly in the gastrointestinal tract. Flushing and skin redness are common symptoms of carcinoid syndrome.

    • Treatment: Treatment typically involves managing the symptoms and may include medications to reduce flushing and other symptoms, as well as surgery, chemotherapy, or radiation therapy to treat the tumors.

What you can do

  1. Continue taking the Ibuprofen as directed for pain relief.
  2. Apply a warm compress to the area to help reduce any swelling or discomfort.
  3. Keep an eye on the lump. If it continues to grow, or if you develop other symptoms, seek medical attention.
  4. Stay hydrated and eat a balanced diet to help your body fight off any potential infection.

What you should look out for

  • If the lump continues to grow or becomes more painful
  • If you develop new symptoms, such as difficulty swallowing, hoarseness, or unexplained weight loss
  • If your flushing episodes become more frequent or severe

Please remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago


People Also Ask


What could cause a hard, immovable lump under the chin?

A hard, immovable lump under the chin could be caused by lymphadenopathy, salivary gland disorders, or a thyroid nodule. It is important to consult a healthcare provider for an accurate diagnosis.


What are the common symptoms of carcinoid syndrome?

Common symptoms of carcinoid syndrome include facial flushing, diarrhea, wheezing, and a rapid heartbeat. These symptoms occur due to the release of certain chemicals by carcinoid tumors.


How can lymphadenopathy be treated?

The treatment for lymphadenopathy depends on the underlying cause. If it's due to an infection, antibiotics or antiviral medications may be prescribed. If it's related to an immune disorder or cancer, other treatments such as immunotherapy or chemotherapy may be necessary.


What should I do if I experience frequent facial flushing?

If you experience frequent facial flushing, it is important to monitor the episodes and consult a healthcare provider. They may recommend medications to manage the symptoms or further tests to determine the underlying cause.

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