Soft and Hard Lumps: When to Seek Surgical Advice

Hello Dr. Lee, I am your patient Jack. I would like to ask you a question?

I have a small area on the inner side of my right thigh that feels somewhat hard and soft at the same time, but it doesn't hurt when I touch it.
It's been there for about two to three years, and I haven't paid much attention to it.
However, a few days ago, while standing up to brush my teeth and wash my face in the morning, I suddenly felt a sharp pain in that area, similar to being pricked by a needle.
This sudden pain occurred three times and then went away, returning to normal.
Later, I visited a dermatologist, who suggested it might be a lipoma or fibroma.
The pain could be due to it growing larger and pressing on a nerve, or it could be pulling on a nerve at a certain angle.
The dermatologist prescribed medication and mentioned that if the pain improves with the medication, surgery may not be necessary.

Dr.
Li, I would like to ask if I need to return for more medication after finishing the current prescription, since I am currently feeling normal and not in pain.
Also, is there a definite need for surgery given my symptoms, or can I just continue with the medication and not worry about surgery if I feel better? I'm quite concerned that it might suddenly hurt again like it did that morning.
I also inquired at the China Medical University consultation desk, and they suggested I see a plastic surgeon for my situation.
Finally, Dr.
Li, if my symptoms have improved with the dermatological medication and I am no longer in pain, do I still need to see a plastic surgeon? Or should I just ignore it since it has been there for a long time without suddenly growing, changing color, or protruding? Currently, it is not very noticeable.
These are the questions I would like to ask you, Dr.
Li.
Thank you.

Wei Jieke, 30~39 year old female. Ask Date: 2016/06/09

Dr. Li Zhonghuai reply Surgery

Hello! The most common skin tumors are lipomas and sebaceous cysts.
If a lipoma is painful or enlarges, surgical removal is recommended.
For sebaceous cysts, removal is also advised.
If a skin tumor is causing you anxiety and discomfort, surgical excision is recommended as well.
Take care! Changhua Hospital cares about you!

Reply Date: 2016/06/09

More Info

When it comes to soft and hard lumps in the body, particularly in your case with a lump on the inner thigh, it is essential to approach the situation with caution and awareness of the potential implications. Based on your description, the lump has been present for a couple of years without causing pain until recently, when you experienced a sudden sharp pain. This change in symptoms is significant and warrants further consideration.

Understanding the Lump
From what you have described, the lump could potentially be a lipoma (a benign fatty tumor) or a fibroma (a benign fibrous tumor). Both of these conditions are generally non-cancerous and can be asymptomatic for long periods. The sudden pain you experienced could be due to the lump pressing against a nerve or due to changes in its size or position. It is not uncommon for benign tumors to cause discomfort if they grow large enough to exert pressure on surrounding tissues.

When to Seek Surgical Advice
1. Persistent Symptoms: If the lump continues to cause pain, or if you notice any changes in its size, shape, or color, it is advisable to seek further medical evaluation. Even if the pain subsides after taking medication, any sudden changes in symptoms should be monitored closely.

2. Duration and Stability: Since the lump has been stable for a long time, this is a positive sign. However, the sudden onset of pain could indicate that the lump is affecting nearby structures. If the pain returns or worsens, it would be prudent to consult a specialist.

3. Consulting a Specialist: The recommendation from the Chinese Medical University to see a plastic surgeon is appropriate, as they can provide a thorough evaluation of the lump and determine whether surgical intervention is necessary. They can also assess whether the lump is affecting any nerves or other structures in the area.

4. Medication and Follow-Up: If the medication prescribed by your dermatologist alleviates the pain and the lump remains stable, you may not need immediate surgical intervention. However, it is essential to follow up with your dermatologist or a specialist to ensure that the lump does not pose any long-term risks.

5. Monitoring: Keep an eye on the lump for any changes. If it starts to grow, becomes painful again, or if you experience any new symptoms (such as numbness, tingling, or weakness in the leg), you should seek medical advice promptly.

Conclusion
In summary, while your current situation may not necessitate immediate surgical intervention, it is crucial to remain vigilant. If the lump remains asymptomatic and stable, continuing with the prescribed medication and monitoring it may be sufficient. However, if you experience any further pain or changes, do not hesitate to consult a specialist. Regular follow-ups can help ensure that any potential issues are addressed before they become more serious. Remember, your health and peace of mind are paramount, so seeking professional advice whenever you have concerns is always a wise choice.

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