What is the cause of a persistent right-sided neck swelling and a lump on the palate for over one month in a female patient, with a negative dental examination and no fever?

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Differential Diagnosis for Female with Right Side Neck Swelling and Lump on Roof of Mouth

Single Most Likely Diagnosis

  • Torus Palatinus: A benign bony growth on the roof of the mouth, which can be asymptomatic or cause discomfort. The neck swelling could be related to a separate issue, such as a benign cyst or lymphadenopathy, but the combination of these symptoms, especially with a negative dental exam, points towards a benign condition like Torus Palatinus for the oral finding.

Other Likely Diagnoses

  • Benign Neck Cyst (e.g., Branchial Cleft Cyst): These are congenital anomalies that can present as a lump in the neck, often on one side. They are usually asymptomatic but can become infected.
  • Lymphadenopathy due to a Viral Infection: Although the patient does not have a fever, some viral infections can cause lymph node swelling without systemic symptoms.
  • Dental Abscess or Infection not Detected on Initial Exam: Despite a negative dental exam, it's possible for a dental infection to cause both neck swelling (due to lymphadenopathy) and a lump on the roof of the mouth if the infection has spread.

Do Not Miss Diagnoses

  • Malignancy (e.g., Oral Cancer, Lymphoma): Although less likely, any persistent swelling or lump, especially in the neck or oral cavity, necessitates consideration of malignancy. Early detection is crucial for treatment outcomes.
  • Tuberculosis: Can cause lymphadenopathy and oral lesions, though it's less common. The lack of fever does not rule out TB, as it can present in a variety of ways.
  • Sarcoidosis: A systemic disease that can cause lymphadenopathy and oral lesions, among other symptoms.

Rare Diagnoses

  • Rhabdomyoma: A rare benign tumor of the muscle that could potentially occur in the oral cavity or neck.
  • Castleman Disease: A rare disorder that involves an overgrowth of cells in the body's lymph nodes, which could cause neck swelling.
  • Kimura Disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, more commonly seen in Asian males but can occur in females and other populations.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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