Presentation on theme: "A lump in the neck. Case 1 A 55yr old man presents to his GP with a progressively enlarging lump at the side of his neck by his jaw. What are the possible."— Presentation transcript:
Examination revealed a non-tender, non- fluctuant fixed lump in front of and below the tragus of the ear.
This was shown to be a parotid lump What else would you need to examine? What else would you need to examine? Parotid (Stensen’s) Duct Parotid (Stensen’s) Duct Opposite upper 2 nd molar tooth Opposite upper 2 nd molar tooth ? pus from opening ? pus from opening VII nerve VII nerve Regional lymph nodes Regional lymph nodes
Causes of parotid swelling Tumour Tumour Mixed tumours Mixed tumours 90% in parotid 90% in parotid Mostly benign Mostly benign Local recurrence big issue if badly excised Local recurrence big issue if badly excised Parotitis Parotitis Mikulicz’ syndrome Mikulicz’ syndrome In sarcoid, sjogren’s, TB In sarcoid, sjogren’s, TB Replacemnt of glandular tissue with lymphocytes Replacemnt of glandular tissue with lymphocytes
Case 2 A 24 yr old man presents with an enlarged lymph node in the right posterior triangle. It is painless but he hasn’t felt well, being tired, off his food, losing weight and getting awful night sweats. What are the possible causes of the enlarged node? What else would you need to examine?