Asymptomatic bilateral facial swelling

Abstract

A 54-year-old Black woman sought treatment at the oral medicine clinic at the School of Dental Medicine at the University of Pennsylvania for evaluation of bilateral facial swelling. The patient endorsed that the swelling had been present for the past 18 months but denied any associated symptoms, including pain, drainage, facial weakness, facial numbness, or any history of facial swelling. The patient denied constitutional symptoms, including fatigue, fever, chills, or unintentional weight loss. She denied history of trauma to the face and endorsed that the swelling had increased slowly over time. The patient denied alleviating or exacerbating factors. She reported that the amount of swelling did not change with oral nutritional intake. The patient denied a history of head and neck cancer and head and neck radiation therapy. Her medical history included hypertension, anxiety, and insomnia. Medications included metoprolol, nifedipine, and olmesartan. Social history included smoking 6 to 7 cigarettes per day for the past 15 years and consuming 1 to 2 alcoholic drinks per month without any history of alcohol abuse or recreational drug use. The review of systems was negative after detailed evaluation. Dr. Almasri was a resident, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, when the work described in this article was conducted. Dr. Gustafson is an associate professor of pathology and laboratory medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Dr. Husson is a professor of clinical pathology and laboratory medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Dr. Shanti is an assistant professor of oral and maxillofacial surgery, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA and an assistant professor of otorhinolaryngology/head and neck surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Dr. France is an assistant professor of oral medicine, Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 S 40th St, Philadelphia, PA 19104