Discovery and Pre-treatment Stage

I’d first noticed a lump under my right jaw line on my upper neck early in the year. It had not been painful but the lump bothered me. However, due to the fact that I was too busy with audit, netball and studies that I totally ignored it.

In the middle of June 2010, as the lump grew bigger, I was concerned as to what is actually growing under my jaw so I went to Klinik Mediviron TTDI Jaya (my company’s panel clinic) and Dr Sharifah Abd Ghaffar referred me to Dr Aminuddin Bin Saim – Consultant Ear, Nose, Throat & Paediatric ENT Surgeon of Ampang Puteri Specialist Hospital (APSH).

Lump - front view.

Lump - view from the left. Thinner jaw line.

Lump - view from the right. Thicker jaw line.

June 25: I went to APSH with my mom and met Dr Amin for the first time. He tried conservative treatment first with a course of antibiotic – Augmentin (but this actually resulted in no change). He then ordered a CT Scan (of the neck) with contrast. Dato’ Dr Azlin Azizan – Consultant Radiologist came in prior to the scan to explain everything the radiographer would be doing and to calm me down as this was my first CT Scan ever. The radiographer then placed a tourniquet around my arm and inserts an IV and connects it to a plastic tubing. The tubing was connected to an injector, and I'd felt a warm rush of fluid (like a rushing heat) into my arm, chest and abdomen as she injected the CT Scan dye which caused some discomfort. I was left alone in the room as the scanner starts working. Now and then a voice came through the intercom to tell me what I was supposed to do. I remembered my heart beating wildly while my anxiety grew. After the test, the IV was removed and because I was in a hurry, I was told to collect the results on August 16.

August 16: Results came back and the scan was read as remarkable by Dr Azlin:

Report

“There is soft tissue lesion seen in the right submandibular space extending into the right sublingual space measuring 5 x 2.5 x 3cm. The lesion appear partly arising from the right submandibular gland. There is NO further cervical lymphadenopathy seen. The left submandibular gland, parotid and thyroid gland appear normal. Nasopharynx, oropharynx, larynx appear normal”.

Radiologist Impression:

“Soft tissue lesion in the right submandibular gland extending into the submandibular space and sublingual space – epidermoid”.

Dr Amin agreed, believing it was a benign tumour. We then decided to have the tumour removed: I was scheduled for surgery on Tuesday, September 21. The plan was to open up my neck, make a quick cut and send a sample of the tumour to the pathologist for immediate examination.

September 3: As I was on study leave, I just dropped by APSH for awhile to pass my insurance details to Zalikha, Dr Amin’ assistant. With my ICAEW Taxation paper coming up soon (Sept-15), I obviously wanted to focus on exams.

September 12: If I read the newspaper, I will always read the sports section first, and then glance at the front page for any hot topic highlighted and if nothing interesting catches my eye, I will turn to the middle of the newspaper and read the cartoon and horoscope and cheer myself, and then read the movie review. I hardly ever read newspapers these days page by page, especially when I am busy revising for my exams. However, of all the days, I didn’t know why I felt like reading everything today; left to right, top to bottom. Quite by chance I came across an article in the Star – “Lumps in the Neck” by Dr Ong Chun Chiang, reminding me of my surgery. After reading it, I just had to cut it and pasted it in my Organizer because it’s a very spot-on article!

Related excerpts from the article:

“Salivary glands swellings - We have three types of major salivary glands (parotid, submandibular and sublingual) and a lot of minor salivary glands. Lumps can arise from any of these glands and they can be benign or malignant. Cancers of the salivary glands come in many different forms. It is advisable to have these lumps removed once detected. Cancers require urgent treatment in the form of surgery and possibly post-operative radiotherapy with or without chemotherapy, depending on their extent and nature”.

SPOT-ON!