From the Guidelines
If you have a small, movable, hard, painless lump deep inside your cheek, the most appropriate initial test would be a contrast-enhanced CT or MRI examination. This is because these imaging tests can help localize and characterize the mass, assess for additional nonpalpable masses, and screen visualized organs for potential sites of primary malignancy 1. When deciding between CT and MRI, consider that CT is more readily available, costs less, and is generally more easily tolerated by patients, although MRI offers improved tissue contrast and can help detect subclinical tumors 1. Some key points to consider when evaluating a neck mass include:
- Obtaining neck imaging in patients deemed to be at increased risk of malignancy
- Using contrast-enhanced CT or MRI to characterize the mass and assess for additional masses
- Considering MRI when a primary tumor of the nasopharynx is suspected or when there is cranial nerve abnormality on physical examination
- Being aware of the limitations of each imaging modality, such as motion artifact and implantable medical devices that preclude MRI scanning 1. It's essential to have a healthcare provider evaluate the lump and determine the best course of action, as proper evaluation is necessary to determine the exact nature of the lump and appropriate treatment.
From the Research
Diagnostic Tests for Lump in the Chest
To diagnose a lump in the chest that is small, movable, hard, and painless, several tests can be run. The choice of test depends on the suspected cause of the lump.
- Imaging tests such as X-rays, CT scans, or MRI scans can help visualize the lump and determine its composition 2, 3.
- A CT scan, in particular, can provide detailed images of the chest and help identify any abnormalities, such as tumors or cysts 3.
- However, it is essential to weigh the benefits of CT scans against the potential risks, including the increased risk of cancer associated with ionizing radiation 3.
Considerations for Test Selection
When selecting a diagnostic test, it is crucial to consider the following factors:
- The size and location of the lump
- The patient's medical history and risk factors
- The potential risks and benefits of each test
- The need for additional testing or follow-up care
Limitations of Available Evidence
There is limited evidence available that directly addresses the diagnosis of a small, movable, hard, and painless lump in the chest. Most of the available studies focus on the imaging of the chest after radiotherapy or the risks associated with CT scans 2, 3. One study is unrelated to the chest or diagnostic tests for lumps 4.