Groin Tumors: When to Seek Further Medical Evaluation

Inguinal tumor has not resolved after two weeks of medication?

I have a lump in my groin area that is darker than the surrounding skin.
It feels slightly raised and is tender to the touch.
When pressed, it feels hard underneath the skin, measuring approximately 5 cm in length and 1 cm in width.
At the end of May, it was smaller and resembled a firm cyst that oozed a small amount of tissue fluid.
I didn't pay much attention to it, thinking it would heal on its own.
By June 10, it had developed into the condition described above.
I visited a gynecological clinic for an examination, and the doctor suggested it was due to tight underwear causing friction, noting that the lymph nodes felt firmer.
The doctor advised me to avoid developing cellulitis and prescribed medication for topical application.
However, after 17 days of follow-up treatment, I only feel a slight reduction in the hardness, and there has been no significant improvement.
1.
Am I at risk of this being a malignant tumor?
2.
Should I seek a consultation in a different specialty for further evaluation?
3.
Is it possible for friction from underwear to cause inflammation in the lymph nodes that would require such a long treatment duration?
4.
Will I need surgery or a biopsy?
Thank you.

kiki, 30~39 year old female. Ask Date: 2019/06/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

A lesion has developed in the groin area that is darker than the surrounding skin, slightly raised to the touch, and tender when pressed.
It feels firm underneath the skin, is approximately 5 cm long and 1 cm wide.
At the end of May, it was smaller, resembling a hard abscess that oozed a small amount of tissue fluid.
I didn't pay much attention to it, thinking it would heal on its own.
By June 10, it had progressed to the current state.
I visited a gynecology clinic for examination, and the doctor suggested that it might be due to tight underwear causing friction, noting that the lymph nodes felt firmer.
The doctor advised that as long as it doesn't develop into cellulitis, treatment with medication would suffice.
However, after 17 days of follow-up and medication, I only feel a slight reduction in firmness, with no significant improvement.
1.
Am I right to be concerned that this could be a malignant tumor?
Answer: It is unlikely to be a malignant tumor.
2.
Should I seek a consultation with a different specialty?
Answer: General surgery would be appropriate.
3.
If it is simply friction from tight underwear causing lymphadenitis, is it possible for it to take this long to treat?
Answer: It is unlikely to be just friction from underwear.
4.
Will I need surgery or a biopsy?
Answer: Initial treatment should be with medication.

Reply Date: 2019/06/28

More Info

When it comes to groin tumors or lumps, it is essential to approach the situation with caution and seek appropriate medical evaluation. Based on your description, you have a lump in the groin area that has changed in size and characteristics over time. Here are some considerations regarding your concerns:
1. Concern About Malignancy: It is natural to worry about the possibility of a malignant tumor, especially when there are changes in size and consistency. The characteristics you describe—such as the lump being firm, painful upon pressure, and having changed from a smaller size to a larger one—can be concerning. While many lumps in the groin area can be benign, such as lymphadenopathy (swollen lymph nodes) due to infection or inflammation, it is crucial to rule out malignancy. The fact that the lump has not improved significantly with treatment raises the need for further evaluation.

2. Changing Specialists: Given that your current treatment has not yielded satisfactory results, it may be beneficial to seek a second opinion or consult a specialist, such as a general surgeon or an oncologist. These specialists can provide a more comprehensive evaluation of the lump, including imaging studies (like ultrasound or CT scans) and possibly a biopsy if indicated. A general surgeon can assess whether the lump requires surgical intervention or further diagnostic procedures.

3. Duration of Symptoms: The duration of your symptoms and the lack of improvement despite treatment are significant factors. While it is possible for a localized infection or inflammation to persist, the fact that you have been on medication for 17 days without substantial improvement suggests that further investigation is warranted. Conditions like cellulitis or lymphadenitis can sometimes take time to resolve, but if the lump is not responding to treatment, it may indicate a different underlying issue.

4. Need for Surgery or Biopsy: If the lump continues to persist and there are concerns about its nature, a biopsy may be necessary to obtain a definitive diagnosis. A biopsy involves taking a small sample of tissue from the lump to analyze it for cancerous cells or other abnormalities. In some cases, surgical removal of the lump may be recommended, especially if it is suspected to be malignant or if it causes discomfort.

In summary, while your initial assessment by the gynecologist suggested that the lump could be due to friction or inflammation, the lack of improvement and the characteristics of the lump warrant further evaluation. It is advisable to consult with a general surgeon or an oncologist for a thorough assessment, which may include imaging studies and possibly a biopsy. Early intervention is crucial, especially if there is any suspicion of malignancy. Remember, it is always better to err on the side of caution when it comes to changes in your health.

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