post

Lumps & Bumps

Not a pleasant topic, but things you should know;
From Lumps & Bumps post on Aches & Joints.
Download the PDF (220 KB), as it appears in the print edition.


Lumps & Bumps: Things to consider when you notice a lump on your body


Over the course of a day, we all poke, rub, and scratch. Usually it’s an itch or a sore. Occasionally we notice a lump! What should we do? Rightly, some of us will worry about it and cannot rest until we find out what the lump is. Others will completely ignore it.

Fortunately, the vast majority of lumps and bumps are benign (see box at end) and do not threaten our lives. But some can be dangerous and require immediate medical attention. So which lumps should we worry about? Which lumps and bumps require a doctor’s care, and which ones can be ignored?

We usually discover lumps and bumps about our hands and feet earlier than if they were in our thighs or buttocks, for example. Our hands and feet don’t have as much soft tissue around them, making it easier to notice even small lumps. Our buttocks, thighs and even the upper arms can hide quite a large mass before we notice.

Feel the size of the lump carefully. Small tumors less than 2 cms are more likely to be benign. Is the lump painful? Benign soft tissue tumors tend to be painless. Does the lump move about as you press on it? A tumor that is not fixed in one place is not growing into adjacent bone or organs. Such mobile tumors are less likely to be dangerous. An important characteristic of a tumor is whether or not it is growing. Measure the size of the mass with a measuring tape and record its size.

A 2 cm lump would be considered a small tumor. However, if the tumor expanded from 1 cm to 2 cms in 2 weeks, then the tumor is growing relatively quickly and should not be ignored.

benign fat tumor lipoma in thigh
Magnetic Resonance Image (MRI) of a thigh, identifying a lipoma – a benign fat tumor, adjacent to the thigh bone.


Patients should contact their primary care physician regarding any newly discovered lumps. In the meantime, perform a thorough self-exam of the rest of your body (including the hands and feet). Look for other lumps or bumps, or areas of skin pigmentation that are new. Make sure to look at the soles of your feet and the palms of your hands.

The doctor may order an MRI (magnetic resonance imaging) exam, possibly with the use of a contrast agent. A surgeon can use the MRI information to decide whether the tumor can simply be removed, or if it requires additional tests.

If the lump is greater than 5 cms, painful, or is growing, the doctor may recommend a biopsy. During a biopsy, a small portion of the lump is removed with a needle and analyzed by an experienced pathologist to determine if the lump is benign or malignant. Malignant lumps can be life threatening (see box) and often require sophisticated care and complex surgical excisions.

“It’s never a waste of a doctor’s time to have a lump or bump evaluated,” states Dr Kevin Raskin, Assistant Professor at Harvard Medical School and Tumor Surgeon at the Massachusetts General Hospital, Boston, MA. A physician should evaluate new lumps and bumps, those that have changed over time, or are causing symptoms. “The over-arching theme is ‘don’t be shy.’ Bring up even the smallest worry with your doctor. An ounce of prevention is worth a pound of cure, and peace of mind is priceless,” advises Dr Raskin.


Benign: (beh-NINE); mild, gentle and non-threatening;
Tumors that generally do not threaten the life of the patient. They very rarely spread to other areas of the body, and often do not need to be treated unless they are bothersome to the patient.

Malignant: (muh-LIG-nunt); tending to spread and infiltrate;
Tumors that may threaten a patient’s life. They often spread to distant organs including lymph nodes and lungs. These need to be treated by experienced physicians.



Comments

  1. Hello Arun,

    I only write because I have now seen 3 doctors about the “nodule” near my tailbone (All in ER I do not have insurance) and none of them seemed to know what they were talking about or care. The first doctor told me it was “probably” a pilonidal cyst. I asked if he was sure and he said “Well, I don’t know. Just keep an eye on it and if it gets inflammed we’ll give you antibiotics.” Okayyyy. Next ER room the younger doctor didn’t even touch it and told me it was probably a cyst and again “Keep an eye on it”. Then he brought in an older doctor and that’s when things got interesting. It went something like.. “We call that a pilonidal… no wait… that’s not a pilonidal… it’s a nodule… it’s not even an abcess!” I asked him what that means and he said “It’s nothing! It means I don’t have to drain it.” Am I being overly concerned or should I be worried about this “nodule”. I looked it up online and found that nodule is just a term used for a smaller tumor. Well if I have a small tumor on my tailbone shouldn’t the doctor be more concerned and at least order an x ray or something? Or because I didn’t have insurance they just wanted to get me out. It doesn’t cause pain, and I don’t believe it has been growing but I could be wrong. It’s located to the top left of my cleft, seems just a bit lower than a pilonidal would be. Don’t know what else to do doc? Should I go to another ER? Or wait it out and just monitor it for now. I don’t want to wait and find out it was malignant and has spread because an ER doc told me “It’s nothing!” Or is a small nodule in that area unlikely to spread unless it gets larger and produces symptoms? Sorry for the long message, just worried and don’t know how many ER’s I can go to before I just give up and monitor. Thank you.

  2. I have a lump on the inside of my right butt cheek and it has been there for a while. I can move it around when I touch it but it has never been painful. It seems to be getting a little larger over the past couple of years. Should I worry that it is slowly growing?

    • Lipoma do tend to get bigger slowly. It may be best to have it checked by your doctor; will put your mind at ease.
      Best Wishes

      • Good afternoon. A little over a month ago I discovered a lump on my outer mid thigh. It was probably a little smaller than a golf ball. I thought it was odd so I’ve been keeping a close eye on it. A month later it has gotten bigger. It is now a little more than 5cm in diameter. It doesn’t move. When I am standing you can’t really see it unless you look hard and I can barely feel it but when I sit down and especially when I cross my legs it is noticeable and I can feel how large it is. There isn’t any pain. I’m trying to get to a doctor because I’m worried about it since it has gotten bigger but I don’t have health insurance right now. I’m working on getting it but I’m not sure when it will take effect. So I’m just researching until I can get to the doctor. Any suggestions or advice? I know you can’t give medical advice….I guess I’m just wondering more if anybody else has had something like this that you know or could share.

        • Sorry to hear about the Health Insurance.
          But there can be so many variables in understanding what is going on with the lump on your thigh, it is best left to a doctor. In your town, are there any walk-in clinics? They may be able to guide you quickly. In many places, the local pharmacy has small clinics run by Nurses; they may be able to take a quick look and let you know if it is important to see a doctor immediately

          Wishing you the best. To your health.
          Arun

          On Turmeric Milk
          https://arunshanbhag.com/2009/06/05/turmeric-milk/

  3. Thanks for this information. I have not felt well for awhile and now-over the past week- I have noticed a lump rt of the lumbar spine. A few days later I had one start on my lt leg inside and slightly below my knee. These are both slightly painful-bruise like feeling w/ palpation. I also have had spots that I can pinpoint on back and breast of extreme tenderness. No lumps there, no trauma either. I have noticed an enlarged and tender rt inguinal lymph node, and one on the back of my head. I had a sore in my mouth so I can explain the one on the back of my head but not the inguinal one. Now I am getting a little nervous. Any ideas?

    • You seem well versed in medical terminology; you also realize that I/we cannot provide ANY medical advice.
      The purpose of this article is essentially to make you aware of the lumps you feel or see.
      Please see your doctor.

      Best Wishes,
      Arun

  4. I have some type of tumor on my upper right thigh. I’ve had several ultrasounds done and the doctors can not determine what kind of tumor. I am seeing a surgeon next week about removal because it grows and shrinks and it strangly itches after I finish working my 12 hour shifts. I am worried because I have Protein S Difficiency and I don’t want to risk bleeding. Also, I still haven’t found out if it’s a lipoma or something else.

  5. This was an interesting post,but now it’s gotten me mildly worried. A week a go I discovered a strange lump on the inside of my lower left butt cheek that is about 3 cm. It wasn’t there before and seeminly over night it was there. Im not sure what it is,but I dont intend to find out. I am hoping it will just go away on its own.

    • Follow some of the guidelines listed here; importantly is there pain and is it growing? It is also likely that the lump has been there for a while, you just did not notice it; if it keeps growing, or at your next visit, show it to a doctor.

      Best wishes.

  6. Absolutely right, Saroj!
    Medicine here in the US appears to be “to those who have insurance!” while more than 45 millions do not have health insurance!

    But I hope there is enough info here to know if the lump is dangerous!

    🙂

  7. Ahh, this is a pretty interesting post. Sometimes it is hard to tell which lumps are benign and which are malignant. Though I suppose, the one boundary preventing people from freely going to doctors to have these lumps examined is the cost that it sometimes entails for the biopsies and possibly subsequent tests. Changing that, though, is in the hands of the government.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s