Discovering a lump or swelling in your cheek can be unsettling. While such a finding naturally prompts concern, many causes of a “ball in the cheek” are not serious. This article explores various reasons why this symptom might occur.
Common Causes of a Cheek Lump
Lumps in the cheek often stem from common, benign conditions. Salivary gland issues frequently cause swelling due to blockages like mucoceles, ranulas, or salivary stones (sialolithiasis), which impede saliva flow. This buildup presents as a lump and can lead to infections (sialadenitis), characterized by inflammation, pain, and sometimes pus.
Lymph nodes, small glands that filter harmful invaders, can also swell in the cheek area. This swelling, called lymphadenitis, typically occurs in response to infections or inflammation in the head and neck. Common culprits include viral, bacterial, dental, and ear infections. Swollen lymph nodes indicate your immune system is fighting an illness.
Cysts, typically fluid or debris-filled sacs, are a frequent cause of cheek lumps. Common epidermoid cysts are benign nodules filled with keratin, forming anywhere on the body and growing slowly. Rarer sebaceous cysts arise from sebaceous glands and contain sebum.
Bacterial infections can lead to an abscess, a collection of pus that forms a painful lump. Dental issues, such as a tooth abscess or severe tooth decay, are common origins for cheek abscesses. These infections can spread from the tooth to surrounding tissues, causing significant swelling and pain. Skin infections can also result in abscesses, presenting as red, swollen, and tender areas.
Direct trauma or injury to the cheek can cause immediate swelling or a hematoma, a collection of blood under the skin. A hematoma forms when blood vessels are damaged, allowing blood to escape into surrounding soft tissues. Many resolve on their own, but larger ones can cause prolonged swelling and discoloration.
Benign growths can also appear as cheek lumps. Lipomas are common non-cancerous lumps composed of mature fat cells, typically soft, movable, and usually painless unless they press on a nerve. They are often encapsulated and grow slowly. Fibromas are another type of benign growth, consisting of connective tissue, which can also appear as a lump.
When to Consult a Doctor
A cheek lump often resolves on its own, but certain signs suggest it’s time to seek medical advice. If the lump persists for more than a week without improvement, a professional evaluation is warranted. Any noticeable changes in the lump’s characteristics, such as rapid growth, alteration in shape, or a change in color, should prompt a visit to a healthcare provider.
If the lump is accompanied by pain, tenderness, redness, or warmth, especially if symptoms worsen, it could indicate an infection or inflammation. A fever or chills alongside the cheek lump also points towards an underlying infection. Should the lump interfere with normal functions like chewing, swallowing, speaking, or even breathing, immediate medical consultation is advised.
Neurological symptoms, such as numbness, tingling, or weakness in the face, when associated with a cheek lump, require prompt medical evaluation. If the lump feels hard or fixed (not movable), or if it is painless but steadily growing, these are signs a doctor should assess. Unexplained weight loss or persistent fatigue in conjunction with a cheek lump also require medical examination.
Diagnosis and Treatment Approaches
When consulting a doctor for a cheek lump, the diagnostic process typically begins with a comprehensive medical history and a physical examination. The doctor will inquire about the lump’s onset, duration, and any associated symptoms like pain or difficulty with movement. A physical examination involves careful palpation of the lump to assess its size, consistency, mobility, and tenderness.
Following the initial examination, various diagnostic tests may be employed. Imaging techniques are commonly used to visualize the lump’s internal structure and relationship to surrounding tissues. An ultrasound is often a first-line imaging tool, assessing the lump’s size, location, and whether it is solid or fluid-filled. For more detail, a CT scan or MRI may be performed to identify the lump’s composition and potential spread.
Blood tests might be ordered to check for signs of infection or inflammation, such as an elevated white blood cell count or inflammatory markers. If there is suspicion of malignancy or if the lump’s nature remains unclear, a biopsy may be necessary. This involves obtaining a tissue sample for microscopic examination. A fine needle aspiration (FNA) biopsy uses a thin needle to extract cells, while an excisional biopsy involves surgically removing the entire lump or a portion for analysis.
Treatment for a cheek lump depends entirely on the underlying diagnosis. For bacterial infections, such as abscesses or sialadenitis, antibiotics are typically prescribed. Anti-inflammatory medications may also reduce swelling and discomfort. Abscesses or certain cysts, like mucoceles, may require drainage to relieve pressure and remove accumulated fluid or pus.
Surgical removal is common for persistent cysts, benign tumors like lipomas or fibromas, and any growths confirmed to be malignant. Surgery aims to completely excise the lump, minimizing recurrence. In cases of minor lumps expected to resolve naturally, such as small hematomas or mild inflammatory swellings, observation may be recommended, often with supportive care like warm compresses or pain relievers.