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Lesion found in left paraphangeal space after vocal cord surgery.
Will try to keep this brief and only include relevant info. My neck surgeon is being very vague and I’m just looking for what can be expected.
I was diagnosed with a paralyzed vocal cord September 22. CT scan of head, neck and chest showed a few sub cm nodes on neck but nothing significant to account for the paralysis.
I had surgery on my vocal cord in January 2023.
3 weeks later, in February 2023 I had a CT and MRI #1 due to some post surgery issues. Both CT and MRI noted a ‘lesion’ centered in the left paraphangeal space and report said ‘pathological lymph node or nerve sheath tumor’ showing restricted diffusion and measuring 10x7mm. I can’t feel anything odd and had no idea this was an issue until the scan to check the surgery.
Scans were reviewed by team and I had MRI#2 with and without contrast 4 weeks later in February 2023. The node was see again and noted to be ‘ 8 x 11 x 15 mm left parapharyngeal node. This is oblong in configuration’. I’m
it sure how these 3 measurements compare to the first ones? I don’t think there was anything else concerning except the small size increase and I expected this to be the end.
But Surgeon called 3 days after scan and asked me to come back in 3 months for MRI#3. I had that in late May 2023 and the report was more vague, didn’t give an exact measurement but said node looked similar to previous. .
Surgeon called and says we can wait 6 months but need MRI #4 before the end of the year. He casually mentioned that the location is ‘extremely challenging’ and but the lesion is under the size to remove. Nothing else and I sort of freeze when talking to him.
I guess I am wondering if the doctors are thinking this is not good and it will eventually grow so they want to catch it? Or if they are just being extremely cautions and proactive? Everything I read says as long as short axis is < 1 cm all is ok and even if bigger it’s still rare for concern. I asked if this is what caused the paralyzed vocal cord from last year and DR says no but that seems like a bizarre coincidence.
4 MRI’s in under a year just seems like a lot.
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Sounds like they want to keep looking at it, perhaps because they haven't a clue where to go from here. Waiting for something to be big enough to operate is to me the last thing they should be doing. Get to an ENT or Cancer specialist sooner than later would be my advice. 1/2-inch diameter lesion is not something you should wait on. Have you thought about sending your records to a cancer clinic?
Thank you for the reply. I actually just reread the summary of our phone call and my doctor notes that it remained stable at 8mm and ‘given the difficulty and risk of accessing this location’ he recommends another MRI vs biopsy. He has said this before and I get the impression he’s not sure the area is accessible? He is a neck surgeon in the Otolaryngology Department at a major Boston hospital and I know the scans have been reviewed by oncology but now wonder if I should get a second opinion?
Second opinion might be a good option. There will probably be others who will jump into this discussion in next few hours/days, perhaps someone who has had the exact issue you are facing. I’m more an oral cancer guy. Let’s see what turns up. In the meantime I am sad you have to go through this, especially with the unknowns. I also want to welcome you to the head and neck group although a welcome to a summer picnic it is not. However, you are among friends.
Wow. I get a bit confused with everything you said because i am not familiar with your condition or some of the terminology but i think its important to ask for your doctor to clarify your concerns. Get another opinion if you still have doubts with your physician answers. Questions left unanswered can eat at you and you need peace of mind. Wishing you the best