Yesterday in clinic I was approached by this lady, who described a painless mass growing on the left side of her face for 8 months. She’d never consulted a doctor about this. Her general health history was unremarkable. No fevers, weight loss, or unusual sensation of her head or neck. On exam, the mass is rather firm, non-fluctuant, non-tender. It encompasses roughly the dimensions of a large parotid gland. Jaw mobility is only slightly diminished.
And now take a look at her skull X-ray. No CT or MRI is available. Her basic laboratory tests show not abnormality except a sedimentation rate of 110. What is YOUR provisional diagnosis? What tests or procedures would you pursue that would be appropriate for a low-resource setting, with no consultants?