Right Cheek Swelling

Posted by plbb1 @plbb1, Nov 24, 2021

My right cheek has been noticeably swollen since June 2021. I didn't notice it until
3 1/2 mos after 2 co-vid vaccines. Also, a small lump on right jaw. After my booster in September my right cheek swelled even more. Since October I sometimes have numbness/tingling on that side of face and in mouth. Been to dentist, primary, and ENT. CT didn't show anything suspicious. I have RA and am on methotrexate and humira. I'm at a loss.

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@plbb1, that is disconcerting. I found this article:
– 7 Possible Causes of a Movable Lump on Your Jaw Bone https://www.healthline.com/health/movable-lump-on-jaw-bone

Is there anything in the article that may give insight to your issues? What have your primary physician and/or ENT suggested as next steps?

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@plbb1 Let's get honest, and step up your diagnostic work up a couple notches. First, some simple signs and symptoms. You say you have RA, and are on methotrexate and Humira. And you have a couple lumps. Do you have a geneticist?
1. You have RA, and take Methotrexate and Humira, which means you have at least some medically-recognized symptoms of genetic disorders.
2. With this much, and your lump growths, a genetic work-up is called for. Your doctor can (and should) call the Medicare provider number and arrange for that. It is simple, and takes a few minutes for both you and your care team. Trouble is, many doctors are too lazy to make that call.
3. If you do not wish to work through Medicare, just call one of the better labs yourself and arrange the testing. It won's be as thorough and accurate as those coming through Medicare, but will probably show up enough to get you into the route for a full workup. The simplest testing will run less than $100, and might suffice. It will usually show at least several hits of pathogenic DNA. Some of the labs offer workups for small prices that are as accurate as the Medicare stuff. Others are almost as good. Sequencing.com , LivingDNA, Apollo, Dante, 23 and Me, Ambry and a bunch of others are good.
4. Consider some possibilities of what you might have. Personally, I would start with considering any of the myeloma family of issues and cancers, such as RA, and Amyloidosis, and such. I have this whole family of stuff, with lumps all over my face and body. A skin disorder, called cutis laxa, will sometimes do this. I also have Clarkson's (CALR), which seems to describe you, and is one of the most deadly and dangerous. It has fragile capillaries which break open and spill blood around your skin, making lumps in your internal organs, such as your thyroid, esophagus, liver, lungs, whatever. It is part of the Gelsolin (Finnish Amyloidosis) family.
5. Most importantly, get the testing done, and write down ALL your med history. And get your doctor to take your needs seriously.
6. Consider yourself now a student, because you will have to do most of your own searching, as many doctors are unwilling to work with Medicare. Make yourself at home with http://www.omim.org and other parts of the NIH operation oldkarl

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@colleenyoung

@plbb1, that is disconcerting. I found this article:
– 7 Possible Causes of a Movable Lump on Your Jaw Bone https://www.healthline.com/health/movable-lump-on-jaw-bone

Is there anything in the article that may give insight to your issues? What have your primary physician and/or ENT suggested as next steps?

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I think allergic reaction resonated in terms of the swelling. My ENT did 2 CT scans in October. One of the right side of my lower face including jaw and neck. Did not show anything suspicious. He also did a CT scan of my sinuses since I have a history of chronic sinutitis. It show some inflammation of the sinuses, but not a lot. Because of some off and on numbness on that side of my face and mouth that started 2 weeks after my booster (Sept 29), he is referring me to a neurologist.

More background info -I noticed the lump and swelling initially 3 1/2 mos of the first 2 covid vaccines I had in February. These never completely went away before I got the booster. Both my primary and rheumatologist said to get the booster even though I told them what was happening. The very next morning after my booster, my face was swollen more. The right side is still puffy.

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@plbb1 I have gone through a similar thing. Except mine is not a lump but multiple episodes of diffused right side face swelling (cheeks, under the eye, forehead, upper lip). I went to several specialists – PCP, dentist, oral surgeon, ENT, rheumatologist, immunologist/allergist, ophthalmologist, dermatologist head & neck specialist. I got MRI, CAT-scan, dental panoramic x-rays, extensive blood work and nobody could figure out what was going on. Only thing that stood out was elevated IgE which the doctors said does not result in any solid conclusions. I am not on any prescription drugs. I am not determined to be allergic to anything specific. I have done courses of Allegra, Zyrtec and Benadryl and it is not clear if it helped. I was also on a 10 day course of Augmentin (antibiotic), and that did not help. My symptoms first appeared, two weeks after the 3rd dose (booster) of the COVID-19 Moderna vaccination. After the second dose of the vaccine, I had gotten some tightness and pain on one side of the face, but I do not remember it being swollen and it resolved within a day. However, after the booster, I have had 5-6 episodes that last days to weeks. I am not sure if the vaccination caused it. If you need more details, please feel free to contact me.

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Do you wear dentures? I had a problem with dentures on the bottom that caused my inside right cheek to swell, I kept going back to the denturist to fix where it was rubbing, he wouldn't fix, so they made another set & identical to last so I stopped wearing them. I have sjogrens & have lost all but four teeth plus I have one implant, then had 8 teeth pulled for lower dentures. When I broke my ankle the emergency room Dr asked if I wore them & I told her I stopped wearing them because my cheek was swollen, & she told me because I get infections I can never wear dentures because it can lead to cancer. It took a year for that swelling to go down. I mentioned to my dentist & tech said she never heard that & the dentist said quietly yes its true. Wish they had said there might be an issue with some people.

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@anniemaggie

Do you wear dentures? I had a problem with dentures on the bottom that caused my inside right cheek to swell, I kept going back to the denturist to fix where it was rubbing, he wouldn't fix, so they made another set & identical to last so I stopped wearing them. I have sjogrens & have lost all but four teeth plus I have one implant, then had 8 teeth pulled for lower dentures. When I broke my ankle the emergency room Dr asked if I wore them & I told her I stopped wearing them because my cheek was swollen, & she told me because I get infections I can never wear dentures because it can lead to cancer. It took a year for that swelling to go down. I mentioned to my dentist & tech said she never heard that & the dentist said quietly yes its true. Wish they had said there might be an issue with some people.

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I had the booster, for seniors its a super dose and yes it hurt for several days, but I am used to pain so waited it out.

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On occasion, my husband's cheek and jaw swelling with accompanying pain. it comes on suddenly, usually while eating. After several episodes and trips to ER while traveling, and a then follow up with ENT he learned it is a blocked parotid gland. The ENT also had him come to office if it happened again. Doctor examined him and there is no lump. He told him to suck on lemon drops or some sour candy to increase saliva, and it will disappear. So far he has not needed to do any other follow-up. He does keep a package of sour candy on hand.
Not related to Covid or vaccine as it began to occur too many years ago.

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@plbb1

I think allergic reaction resonated in terms of the swelling. My ENT did 2 CT scans in October. One of the right side of my lower face including jaw and neck. Did not show anything suspicious. He also did a CT scan of my sinuses since I have a history of chronic sinutitis. It show some inflammation of the sinuses, but not a lot. Because of some off and on numbness on that side of my face and mouth that started 2 weeks after my booster (Sept 29), he is referring me to a neurologist.

More background info -I noticed the lump and swelling initially 3 1/2 mos of the first 2 covid vaccines I had in February. These never completely went away before I got the booster. Both my primary and rheumatologist said to get the booster even though I told them what was happening. The very next morning after my booster, my face was swollen more. The right side is still puffy.

Jump to this post

@plbb1 do you have any updates? Hope you are well.

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@colleenyoung In reference to my previous post (copy-pasted below for convenience), do you think a team at Mayo Clinic will look into my case? I have documented my case extremely thoroughly and have all the medical records on hand and the doctors will surely be academically interested in my case. I live in NY but I can think about travelling to MN or we could do virtual visits.

"@plbb1 I have gone through a similar thing. Except mine is not a lump but multiple episodes of diffused right side face swelling (cheeks, under the eye, forehead, upper lip). I went to several specialists – PCP, dentist, oral surgeon, ENT, rheumatologist, immunologist/allergist, ophthalmologist, dermatologist head & neck specialist. I got MRI, CAT scan, dental panoramic x-rays, and extensive blood work and nobody could figure out what was going on. The only thing that stood out was elevated IgE which the doctors said does not result in any solid conclusions. I am not on any prescription drugs. I am not determined to be allergic to anything specific. I have done courses of Allegra, Zyrtec and Benadryl and it is not clear if they helped. I was also on a 10-day course of Augmentin (antibiotic), and that did not help. My symptoms first appeared, two weeks after the 3rd dose (booster) of the COVID-19 Moderna vaccination. After the second dose of the vaccine, I had gotten some tightness and pain on one side of the face, but I do not remember it being swollen and it resolved within a day. However, after the booster, I have had 5-6 episodes that last days to weeks. I am not sure if the vaccination caused it. If you need more details, please feel free to contact me"

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Have you seen a neurologist? The swelling and pain may indicate trigeminal nuralgia. My daughter visited dentists, endodontists, allergists, and ents before finally being referred to a neurologist and diagnosed with trigeminal neuralgia.

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@gnandanpai

@colleenyoung In reference to my previous post (copy-pasted below for convenience), do you think a team at Mayo Clinic will look into my case? I have documented my case extremely thoroughly and have all the medical records on hand and the doctors will surely be academically interested in my case. I live in NY but I can think about travelling to MN or we could do virtual visits.

"@plbb1 I have gone through a similar thing. Except mine is not a lump but multiple episodes of diffused right side face swelling (cheeks, under the eye, forehead, upper lip). I went to several specialists – PCP, dentist, oral surgeon, ENT, rheumatologist, immunologist/allergist, ophthalmologist, dermatologist head & neck specialist. I got MRI, CAT scan, dental panoramic x-rays, and extensive blood work and nobody could figure out what was going on. The only thing that stood out was elevated IgE which the doctors said does not result in any solid conclusions. I am not on any prescription drugs. I am not determined to be allergic to anything specific. I have done courses of Allegra, Zyrtec and Benadryl and it is not clear if they helped. I was also on a 10-day course of Augmentin (antibiotic), and that did not help. My symptoms first appeared, two weeks after the 3rd dose (booster) of the COVID-19 Moderna vaccination. After the second dose of the vaccine, I had gotten some tightness and pain on one side of the face, but I do not remember it being swollen and it resolved within a day. However, after the booster, I have had 5-6 episodes that last days to weeks. I am not sure if the vaccination caused it. If you need more details, please feel free to contact me"

Jump to this post

@gnandanpai, if you would like to find out if you can be seen by specialists at Mayo Clinic, I suggest you contact Mayo MN to inquire and request an appointment.

Mayo Clinic welcomes both new and existing patients for virtual and in-person care, including elective surgeries, in adherence with federal and state executive orders and guidance.

Video and phone visits also can be great options for appointments before, after or in place of face-to-face care. Appointment coordinators will recommend a virtual visit if it best fits your individual needs.

Here's the contact information to find out more and next steps: http://mayocl.in/1mtmR63

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I had a salivary gland infection (looking at the anatomy, you can see three glands along the jawline). I have had a cyst (salivary stone) or two come and go..For pain, try lemon drops to open up the Eustachian tubes, gently massage the area and use moist heat in the area. It is a strange thing, possibly related to dry mouth. Maybe something with sinus is going on with your cheek? Or, TMJ? Dentist told me to use ACT, or similar, xylitol mouthwash to take care of bacteria. These are just part of the weirdness of the disease. I look up the anatomy of the area so I can describe what is going on to the Dr and have been pretty successful with ice/heat, lidocaine patches, PT and other non-drug treatments. Of course, I am on the usual for MCTD and not much for supplements besides magnesium, D3 and B12 from the Dr.

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