Hi

I have a small lump under the back of front lower tooth between tongue and lower front tooth which is not visible but if I put my finger and press deep I can feel hard lump.

Even ENT doctor also felt the lump, he ordered CT scan which did not show anything. Then he did FNA biopsy which came back as no malignacy identified.

Now Doctor is thinking of doing excisional biposy with full ANESTHESIA.
Should I request him do another FNA instead off
excisional biopsy?.

I am worried about excisional biopsy becasue if it is malignant then I may need another surgery.

Right now i am going to a doctor in Ireland Cancer Center, Cleveland. If it is malignant I would like to go to the best hospitals like John Hapkins or Sloan and have surgery and treatment there. I dont want to have half surgery here and half surgery at different cancer center. Please suggest what should I do?

And also you have any idea why did my lump did not show up in CT scan?

Thank you for your time.

First....find out what you are dealing with. It's your only option. If the dr. feels that the surgical biopsy is needed, then you should be very thankful that he is looking out for your best interests. You have had a negative fna.....What if the next one is neg. also? You won't know any more than you do now. Go the next step, find out, and then make a plan. If you do get a diagn. of cancer, then you will be equipped to then choose the best place to go next. You can always take your results with you....or the next place can access them, with your permission. Most people get sev. opinions anyway.

Get the biopsy. Find out what you are dealing with. and go from there. Good Luck!

Colleen

Thank you for the reply.

While doing Excisional biposy is there possibility of spilling of the cells on nearby tissues and causing recurrence in future if it is malignant.

Or should I request the doctor treat it as malignant and do surgery removing the lump with good margins??

Or if he has any doubts about the lump after opening it, take small tissue for biopsy and close it without removing entire lump???

I am sorry for many questions.

Brian, Gary or anyone - any suggestions from you please!

Thank you

columbus ..

Unfortunatley ..that is the choice and risk many of us take . We let them cut into it to find out what it is , I did with mine the 1st time, not knowing and the med prof strongly believeing that there was no cause for concern of cancer , BOY were they wrong. But we have to do what we have to do to find out what we are up against is my belief and I think the doctors are aware of what they are doing in most cases, you said you are Doctoring at a cancer center so You should be in good hands !

Hello

I met the doctor yesterday and he said that
that may be bone growth which he said is Mandibular Torus and thats why it is not showing up in CT scan.

He asked me whether we will wait for another one month
or do excesional biposy, I requested him to do the excisional biopsy, since his schedule is full I got appointment for excisional biopsy on May 15th.

two weeks from now for excisional biopsy and one week for pathology report, so three weeks to know what it is?. I am worried, I can not wait three weeks to know what it is.

Is there anything I can do to move the things fast, Can I request him to have MRI or PET scan or another FNA??

what I got from internet about Mandibular Torus is
they form only on lingual surface of the mandible near the bicuspid tooth, mine is well below the frontal lower tooth between tongue and tooth.

help me guys what do you suggest me to do?

The problem with fine needle biopsies is the needle can miss the part that has the cancer cells, that's why an excisonal biopsy would be preferable at this point. I know the waiting is horrible, that is all we seem to do. Tell the doctor how worried you are, see if he move your appointment up. If not, take any cancellation he gets and get some anti anxiety meds to calm you down.

Take care,
Eileen

Eleen

Thank you, but I think excisonal biopsy has got disadvantages like multiple surgeries, high reccurence rate etc.

I think repeating FNA 3 or 4 times is better idea
if dignosis is not known. Because FNA takes few minutes and there is no pain and results will be in one or two days and there are no risks.

With out knowing what it is and doing excisonal biopsy there is always risk for reccurence unless you do radiation also in surrounding tissues.

I am wondering where you have gotten the idea that excisional bx might cause a recurrence? As far as I know, and the medical literature shows, this has never been proven to be a fact but rather a myth. Also, there was some thought years ago that FNA MIGHT cause cancer cells to spread, but that was disproven by several research studies.

In most cases, the biopsy itself is not the definitive treatment, it is only used for diagnosis. Once the diagnosis is determined, then further treatment is decided upon - be it more surgery, radiation, chemo, or a combination.

This site from the Mayo clinic has an interesting section on "debunking cancer myths" with this being one of them. http://www.mayoclinic.com/health/cancer/HO00033

Your drs should be able to help you make the right decision - you are being seen at a comprehensive cancer center, which is what any of us would recommend.

I wondered when someone was gong to hit on this. If this was true, how could we do biopsy at all or even resect tumors. Please read the section on metastasis to get some insights on all the defenses the body has to prevent spread of disease. One of the least known is turbulence. Me2 is right in my opinion. Besides, multiple FNB's are still no guarantee that the needle is going to hit the area that acutally has malignant cells in it. It is a good tool, but compared to a punch or incisional biopsy, never the final gold standard.

Tori can happen anywhere, they are discussing where they are MOST COMMON. They are also common on the maxillary arch as well. They are nothing to be concerned about unless they grow to a size in which they interfer with some function.