From Volume 46, Issue 11, December 2019 | Pages 1078-1079
A diagnostic conundrum of a firm, left submandibular node presenting in a 35-year-old female with a history of pain and persistent swelling is described. This paper aims to educate readers on the differential diagnostic dilemma that may be faced in general practice and discusses the importance of shared care in a multidisciplinary setting.
This case report details the diagnostic difficulties encountered in the management of a firm, hard swelling in the submandibular region associated with multiple enlarged cervical lymph nodes presenting in a 35-year-old female patient.
A 35-year-old female was referred by her general dental practitioner regarding a radiolucent lesion in the mandibular left second premolar and first molar regions. The patient on attendance reported having a left submandibular region swelling which had been present for 3 weeks. The swelling was initially painful, however, this had reduced recently and the patient reported mild tenderness on palpation. Extra-oral examination revealed a tender, firm, 3 cm swelling in the left submandibular region, as well as multiple enlarged cervical lymph nodes. Intra-oral examination showed healthy oral mucosal tissues and no buccolingual bony expansion of the mandible in the left premolar and molar region. No teeth were tender to percussion, pressure or palpation and all adjacent teeth, excluding the endodontically treated mandibular left second premolar (LL5) and first molar (LL6), responded positively to sensitivity testing using Endo-frost (Coltene). Radiographically, there was a radiolucency associated with the endodontically treated LL5 and LL6 (Figure 1).
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