Enlarged Supraclavicular Lymph Nodes with Basal Cell Diag.

jbprof · New User Joined: 07 Jan 2007 Posts: 1

I heard back from my dermatologist that the biopsy of a lesion on my chest came back positive for basal cell carcinoma. This is certainly troubling by itself, especially since I am only 29... however I am more concerned about my left-side supraclavicular nodes that have been swollen for the last 3 months. They could have been enlarged for longer, but I only discovered them about 3 months ago.

I was concerned when I first discovered that the nodes were swollen, mainly because I had not been sick at all and I had some limited knowledge that the supraclavicular nodes tend to swell up with more serious problems. I went to my GP and he ordered an ultra-sound which confirmed the enlarged nodes... but they were apparantly not large enough to warrant a biopsy. After another month passed and the nodes were still enlarged, I went to see an Ear,Nose,Throat Doc. He ordered a CAT scan... this too confirmed the enlarged nodes. However, just like the ultra-sound I was told that the nodes were not big enough (9mm was the largest, not sure if that was width or length)to warrant a biopsy immediately unless I really wanted one. Since I didn't have any other worrisome bodily symptoms, I didn't push for a biopsy. Somewhere in between the ultrasound and the cat scan, I had chest xrays done. They came back 'normal'.

Another month goes by and the nodes remain the same for the most part. However, I started to pay attention to patch of skin on my upper left pec just below my collarbone. It originally appeared in late August and resembled an ingrown hair. Over time it morphed into a 1cm circular lesion that looked very similar to a tinea/ringworm infection. It also itched intermittently, so I assumed it was fungal in nature. When it didn't go way with anti-fungal creams I went to the dermatologist. They did a biopsy on Dec 28th. I received the call yesterday that it was cancerous. I've read everywhere about basal cell cancers not metastisizing, but I am very worried about having palpable sc lymph nodes.

The nodes have not gotten any larger than they were 3 months ago when I first discovered that they were enlarged. They do seem to fluctate in size though.. some days smaller than others, but the deviation is not great. So, my perception of the size change could be in error. They feel firm/rubbery, not painful. The one that is most superficial feels mobile to me as well as to the doctor.

So I am wondering, is it possible to have an immune reaction to the basal cell lesion that would cause my nodes to enlarge due to a natural defense mechanism? In other words, how likely/possible is it that my supraclavicular nodes would swell and not be cancerous? Could it be just an immune response that will subside after my Mohs Surgery? Or should I rush off to hospital for lymph node resection?

taz · Regular Joined: 31 Oct 2006 Posts: 12

Hi

Usually nodes are only noted as clinically worrisome when they exceed 1cm - I note yours are borderline and this is probably why a biopsy wasnt performed.

Basal cancer very very rarely spreads so it is unlikely to be related. My guess it is some sort of immune response to something going on elsewhere - those nodes cover quite a large area and it could be an occult infection/reaction elsewhere.

The human body is given to strange swellings/lumps and bumps and unless you examine every single inch of your body regularly it is quite possible that this may have been this size for years without you even noticing. When I did my medical oncology training, we studied cancer of the mouth and larynx. I then started poking around at my own tonsils which were very lumpy and weird looking and absolutely convinced myself I had tonsil cancer because they were such a weird shape. They had probably been like that for years but because I dont tend to poke around in my mouth a lot I hadnt even noticed. Needless to say the weird shape was normal for me.

I understand your heightened sense of anxiety because of the BCC - this is the most common skin cancer and in 99.99 % of cases it is localised and does not spread. This makes it a most unlikely candidate for the lymph node swelling.

Hope this helps

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