Benign Tumors: Evaluating Surgical Options and Symptoms - Otolaryngology

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Inquire about the management of tumors?


Hello Doctor, in early May, after fainting, a subsequent CT scan revealed a tumor near my neck close to the tonsils.
I was referred to a larger hospital for further examination, and later an MRI showed that the images appeared as multiple small nodules rather than one larger mass, with some encasing the carotid artery.
The doctor mentioned that this condition is quite rare.
Initially, a CT-guided biopsy was planned, but the radiologist assessed the risk as too high due to the proximity to the carotid artery.
Eventually, the doctor performed a fine needle aspiration to extract lymphatic tissue, and the results indicated that it was benign.

I would like to ask the doctor how to self-assess the need for surgery given that the results are benign.
Currently, I still have the following symptoms: 1.
Occasionally, I experience pain on the right side of my tonsil (about twice a day, more noticeable at night, but it doesn't wake me up).
2.
When eating, the first bite on the right side near the parotid gland feels sour.
3.
Sometimes I have headaches; riding a scooter puts pressure on my head, making it difficult to wear a helmet for long periods; currently, I can only commute by subway.
4.
While eating, I feel like something is pressing against my chin; it seems to have improved a bit and is not as obstructive now.
5.
I noticed about a week or two ago that I had difficulty lifting my arm, which caused pain; I was referred from rehabilitation to neurosurgery, and the assessment indicated that the tumor is located between the C2 and C3 vertebrae, positioned quite high, which is not significantly related to arm nerve compression, and there is no numbness.
However, my right hand has recently shown some improvement in strength.
Now that it is early June and I have known the results to be benign, I am still in the observation stage.
I heard the doctor mention that only traditional surgery is possible, and it is close to the carotid artery.
Thank you, doctor, for taking the time to respond amidst your busy schedule.

Zuo guo chuan ci guo de bing ren, 30~39 year old female. Ask Date: 2020/06/13

Dr. Zheng Jueyi reply Otolaryngology


Hello, if the results of a biopsy are benign, whether surgery is necessary primarily depends on whether the clinical symptoms are bothersome or affect normal daily life, or on the rate of tumor growth during regular follow-ups.
Of course, the risks associated with surgery must also be taken into consideration.
It is recommended to have regular follow-ups and discuss further with your physician.
Wishing you peace and health! Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/06/13

More Info


Understanding benign tumors, especially in the context of your recent diagnosis and symptoms, is crucial for making informed decisions about your health. Based on the information you've provided, it appears that you have a benign tumor located near your neck, close to the carotid artery, which has raised some concerns regarding the potential need for surgical intervention.


Evaluation of Benign Tumors
1. Nature of Benign Tumors: Benign tumors are non-cancerous growths that do not invade surrounding tissues or metastasize to other parts of the body. They can still cause symptoms or complications depending on their size and location. In your case, the tumor's proximity to the carotid artery and other structures in the neck is significant, as it may pose risks during any potential surgical procedures.

2. Symptoms: The symptoms you are experiencing, such as pain in the right tonsil area, discomfort while eating, and occasional headaches, could be related to the tumor's presence. The fact that you feel discomfort when eating on one side and have experienced pain in your shoulder could indicate that the tumor is affecting nearby nerves or tissues, even if it is benign.

3. Surgical Considerations: The decision to proceed with surgery for a benign tumor often depends on several factors:
- Size and Growth: If the tumor is growing or causing significant symptoms, surgical removal may be recommended.

- Location: Tumors that are near critical structures, such as blood vessels or nerves, require careful consideration. In your case, the tumor's proximity to the carotid artery makes traditional surgery more complex and potentially risky.

- Symptoms: If your symptoms are manageable and not significantly impacting your quality of life, a conservative approach may be taken, with regular monitoring instead of immediate surgery.

4. Monitoring: Since your tumor has been classified as benign, your healthcare team may recommend a watchful waiting approach, where you will have regular follow-ups and imaging studies to monitor the tumor for any changes. This is often a suitable option for benign tumors that are not causing severe symptoms.

5. Consultation with Specialists: Given the complexity of your case, it may be beneficial to consult with an otolaryngologist (ear, nose, and throat specialist) or a head and neck surgeon who can provide a more detailed evaluation of your symptoms and the tumor's implications. They can help determine whether surgery is necessary and what the safest approach would be.

6. Quality of Life Considerations: It's essential to weigh the potential benefits of surgery against the risks, especially considering the tumor's location. If your symptoms worsen or if the tumor begins to affect your daily activities significantly, this may prompt a reevaluation of the need for surgical intervention.


Conclusion
In summary, while your benign tumor does not pose an immediate threat, the symptoms you are experiencing warrant careful monitoring and possibly further evaluation. It's crucial to maintain open communication with your healthcare providers, express your concerns, and discuss any changes in your symptoms. They can help guide you through the decision-making process regarding surgery and other treatment options, ensuring that your health and quality of life remain the top priority. Regular follow-ups and imaging studies will be essential in managing your condition effectively.

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