Could It Be a Tumor? Post-Surgery Symptoms and Concerns - Oncology

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Could it be a tumor?


Hello, doctor.
Due to long-term fatigue and excessive sleepiness, I have sought medical attention multiple times.
After examinations, I was diagnosed with severe obstructive sleep apnea.
Following a maxillomandibular advancement surgery, I began experiencing intense pressure and discomfort in my eyes (around the brow area), a dull headache (a sensation of pressure in the brain), persistent sleepiness, and a strong desire to close my eyes and rest.
This has been quite distressing.
Additionally, I have slight pain in my ear, and my Eustachian tube seems to be malfunctioning, causing discomfort with loud sounds.
Initially, I thought these symptoms were normal post-operative effects due to muscle tension, but they have not improved.
Before the surgery, these symptoms were not as pronounced, but the fatigue from sleep apnea contributed to the overall feeling of tiredness, which the doctor attributed to sleep deprivation.
The surgery was generally effective, but as the surgical site gradually healed over the course of a month, these symptoms persisted.
I consulted an ophthalmologist, who found no issues, and a neurologist performed an EEG, which also showed no problems.
They suggested it might be "tension-type headache," but pain relief medications, massage, and heat therapy have not alleviated the discomfort.
I remember that before the surgery, an ENT specialist noted sinus swelling, but there was no indication of sinusitis.

I researched and found that if it were a brain tumor (such as a pituitary tumor), the headache would typically be more severe and could cause double vision or vision loss.
However, I only experience a strong pressure sensation in the upper part of both eyeballs, and my vision has not significantly changed.
The excessive sleepiness causes my eyes to lose focus involuntarily, leading me to close them.
I also have some issues with my Eustachian tube, and there seems to be a slight pain in my sinuses.
My endocrine function and blood pressure are normal.

These symptoms seem somewhat similar to other conditions, yet they differ significantly, making it challenging to identify the right specialty for diagnosis.
I will continue to seek medical attention at the hospital, but I would like to ask the doctor if it is possible that there could be a tumor in my head? If it were an ENT-related tumor, I would expect symptoms like nasal congestion, nasal discharge, or nosebleeds, but I only have mild nasal congestion.

Hu Hu, 40~49 year old female. Ask Date: 2015/10/14

Dr. Chen Sirong reply Oncology


Is it possible for a 45-year-old male to have a tumor in the head, specifically in the ENT region? I apologize for not being able to assist you in finding the right specialty to determine the cause.
I can only address the possibility of cancer.
You have already consulted a physician who ruled out brain and head and neck tumors, but since your symptoms persist, you are still feeling troubled.
You may consider undergoing an MRI at your own expense to provide imaging evidence to rule out any concerns regarding tumors.
Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2015/10/14

More Info


Based on your detailed description of symptoms following your jaw surgery, it is understandable to have concerns about the possibility of a tumor or other serious conditions. Let's break down your symptoms and the potential implications.


Symptoms Overview
1. Eye Discomfort and Pressure: The sensation of eye pressure and discomfort around the forehead area can be attributed to several factors, including tension headaches, sinus issues, or even referred pain from the jaw surgery. Given that you mentioned a history of sinus swelling, it is possible that residual inflammation or pressure in the sinus cavities could be contributing to your discomfort.

2. Head Pain: The "hidden pain" or pressure sensation in your head, described as a feeling of being constricted, aligns with tension-type headaches, which can be exacerbated by stress, fatigue, or even post-surgical recovery. It's important to note that while headaches can be a symptom of more serious conditions, they are also very common after surgeries, especially those involving the jaw and facial structures.

3. Eustachian Tube Dysfunction: The discomfort in your ears and altered sensations (like discomfort with loud sounds) may indicate Eustachian tube dysfunction, which can occur after surgeries affecting the jaw or surrounding areas. This dysfunction can lead to pressure imbalances in the ear, causing pain and discomfort.

4. Excessive Sleepiness: Your ongoing fatigue and excessive sleepiness could be multifactorial. While sleep apnea can lead to chronic fatigue, the stress of surgery and recovery can also contribute to feelings of tiredness. Additionally, medications used during and after surgery may have lingering effects that impact your energy levels.


Tumor Concerns
Regarding your concerns about a potential tumor, it is essential to consider the following:
- Symptoms of Brain Tumors: While some symptoms you describe (like headaches and pressure) can be associated with brain tumors, the absence of more severe symptoms (such as significant vision changes, persistent nausea, or neurological deficits) makes it less likely. Tumors often present with more pronounced symptoms as they grow and exert pressure on surrounding structures.

- ENT Tumors: Tumors in the ENT region typically present with more specific symptoms, such as nasal obstruction, persistent nasal discharge, or bleeding. Your mild nasal congestion and lack of other symptoms make this less likely as well.


Recommendations
1. Follow-Up with Specialists: Since you have already consulted with an ophthalmologist and neurologist, it may be beneficial to revisit an ENT specialist, especially given your history of sinus issues. They may perform imaging studies (like a CT scan) to evaluate for any structural abnormalities or residual sinus issues.

2. Pain Management: If tension-type headaches are suspected, consider discussing preventive measures with your healthcare provider. This may include lifestyle modifications, stress management techniques, or alternative therapies such as physical therapy or acupuncture.

3. Monitor Symptoms: Keep a detailed log of your symptoms, noting any changes or patterns. This information can be invaluable for your healthcare providers in diagnosing and treating your condition.

4. Consider Psychological Factors: Post-surgical recovery can be emotionally taxing. If you find that anxiety or stress is contributing to your symptoms, consider speaking with a mental health professional.


Conclusion
While your symptoms are concerning, they are not definitive indicators of a tumor. It is crucial to continue seeking medical advice and follow up with specialists who can provide a comprehensive evaluation. Your health and well-being are paramount, and addressing these symptoms with a thorough approach will help in identifying the underlying cause and determining the best course of action.

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