Posted By: DavidTX Worried about neck lymph node - 10-03-2014 10:23 AM
Hello all. Let me start at the beginning. At the end of July I was diagnosed with testicular cancer. Seminoma. So, I have had multiple ct scans and a pet scan in the last two months, although all of the ct scans were of the chest and abdomen, only the pet scan covered my head. So, since about mid August I have had a palpable lymph node on the left mid posterior of my neck. It feels like it is close to a cm maybe a little larger. It is moveable but is not tender to the touch. I had an ultrasound done on the lymph node where they found it to be benign, but it has slightly grown in size since then. I also feel like I have some not really pain but pressure in my right ear, and I have had some canker sores under my tongue that have come and gone over the same time frame. I also have a section in the floor of my mouth that feels swollen and just different that the left.

So, I guess my questions are is it likely for a pet scan to miss some issues that would've been going on in my oral cavity because they were mainly focused on my abdomen?

Do persistent canker sores that come and go in similar but not the same area indicate oral cancer?

How fast would a lymph node with squamous cell carcinoma take to really enlarge over the 1cm threshold?

Thanks in advance for any advice, I am also involved in a testicular cancer forum and I know how great these forums and their members can be.



Posted By: ChristineB Re: Worried about neck lymph node - 10-03-2014 11:58 AM
I would suggest going to an ENT (who treats primarily oral cancer patients) to get checked out. Tell them about the ear pain and lymph node. Im one to always err on the side of caution so its a good idea to get checked out.

Cancerous tumors will not come and go so I doubt the caker sores are anything to worry about. But you still want to let the ENT know you have had issues with it. You just never know.

Im sorry but I dont know how quickly SCC grows. Its probably like everything else, everyone is different and in some it will grow faster than others.

Hopefully you have nothing serious going on. Best wishes!
Posted By: OzMojo Re: Worried about neck lymph node - 10-03-2014 12:32 PM
Hi David. Christine is on the money here, I won't repeat her good advice.

Both my PET/CTs were of my head down to my thighs. I didn't think they did PETs of just the head. And if they were looking at your chest and abdomen why do a PET of your head? The radioactive glucose goes right through you, so I would imagine they would scan the whole body? Maybe others can suggest what happened there.

The PET that showed my tonsil tumour and lymph nodes showed up like a Christmas tree. A blind bat wouldn't have missed them. And while they were at it I know they had a good look at something on my spleen, but concluded it was benign.

An ENT will sort you out. Hope its nothing serious. Good luck with the Seminoma.
Posted By: Cheryld Re: Worried about neck lymph node - 10-07-2014 02:37 PM
HI there... I would push to have them look at the node. It could very well be reactive but better safe than sorry. Usually a sore that doesn't heal is one that needs a biopsy if you're experiencing cankers and they heal that's okay, but the ear pain and node need to be dealt with - even if they are benign. PETs a great but I think - much like the others - MRI and CT - they only pick up tumors of a certain size and can't "see" microscopic cancers - also the results are only as good as the radiologist reading them.

to ease your mind, ask for a referral to a top ENT within the treatment center you were treated at - hugs.
Posted By: newpatient Re: Worried about neck lymph node - 11-01-2014 07:32 PM
Hi David,

I have a few around cervical lymph nodes and under my chin that are just over 1 cm. Been to several ENT's, had ultrasounds, an excisional biopsy, and so far, it seems I have viral lymphadenopathy. These lymph nodes have been around for about 2-3 years or more. I can't really say. What I do know, though, is cancerous lymph nodes tend to be sticky. And, they usually grow fast--someone may correct me with an anecdote here. From most cases I've heard about, they usually find a large lymph node, like over 2 cm, which is noticeably growing over a several week time frame.

Anyways, you should definitely see an ENT about it. A biopsy would be important, given your history.
Posted By: Uptown Re: Worried about neck lymph node - 11-01-2014 10:36 PM
I had a cervical, cancerous lymph node that didn't grow significantly for 6 months. I don't have a clue what a "sticky" node would mean or how it presents. Some nodes are discovered as small as 4 mm. I had a fine needle aspiration done with one that size.
Posted By: newpatient Re: Worried about neck lymph node - 11-12-2014 06:07 AM
Hi Uptown,

Sticky being immobile. I hear doctors say that about cancerous lymph nodes. They tend to stay in-place. Your diagnosis is not reassuring for me. I should get my other enlarged lymph nodes FNA'ed then. So, the lymph node they biopsied on you was 4 mm?? That's super small. All the ENT's I have seen, and I have seen a lot already (over 5 now) have said they will not FNA lymph nodes smaller than 1 cm since they can often miss them.
Posted By: Uptown Re: Worried about neck lymph node - 11-12-2014 06:15 AM
They were image guided. They even took several from it. It would be "sticky", according to your definition. The bigger one was an incisional biopsy. The small one was negative, but it's still there over 3 years later.
Posted By: ChristineB Re: Worried about neck lymph node - 11-12-2014 12:10 PM
I believe Uptown was treated at one of the coutrys top CCC's which could be the difference in biopsying.
Posted By: PaulB Re: Worried about neck lymph node - 11-12-2014 02:23 PM
I had about 10 FNAB's all under untrasound guidance, which makes them more accurate, and some were as small as 3mm x 7mm, and done by a pathologist. Lymph fluid is sticky, so the term can mean differently to others. As far as cancer being immobile, that's not always true. When a cancer is small it can be mobile, and when it gets larger it can attach to structures making it immobile, I had both at times. The doctors also go by other factors such as the shape, thickness, but the only way to tell is through a biopsy.

Good luck.
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