Diagnostic Challenge of Cervicofacial Lymphadenopathy in a Dental Patient: A Case Report

Abstract

Background: Cervicofacial lymphadenopathy is a common clinical finding with a broad differential diagnosis, including infectious, inflammatory, and neoplastic causes. Accurate diagnosis requires a systematic clinical evaluation and appropriate imaging. Aim: To present the diagnostic process and clinical considerations in a case of cervicofacial lymphadenopathy with oral manifestations. Case Presentation: A 34-year-old female presented with a one-month history of dull, persistent pain in the right ear and neck, partially relieved by analgesics. Clinical examination revealed tender, mobile submandibular and submental lymph nodes with no overlying skin changes, and mild gingival inflammation. Orthopantomogram findings were unremarkable. Ultrasonography revealed multiple enlarged lymph nodes in the right submental, submandibular, and Level III cervical regions, with normal thyroid and salivary glands. A final diagnosis of right submental, submandibular, and cervical lymphadenopathy was made, with a differential diagnosis including post-viral lymphadenitis, bacterial infection, inflammatory disease, and malignancy. Conclusion: This case highlights the importance of a thorough history, careful clinical examination, and judicious use of imaging in diagnosing cervical lymphadenopathy. Early and accurate diagnosis in the dental setting can facilitate timely referral and appropriate management. Further investigations and management strategies would be determined based on the underlying cause of the lymph node enlargement. This case underscores the role of oral medicine and radiology in the diagnosis and management of head and neck pathology.