Hard Lumps on the Buttocks: A Guide for Seniors

Q: Hard Lumps on the Buttocks: A Guide for Seniors

Hello! In response to your questions： 1. It is recommended that you schedule an appointment with a general surgeon, but depending on the hospital's specialty, you may need to see a colorectal surgeon. 2. Whether the mass requires surgery depends on the underly

There is a hard lump in the buttock?

Hello, Doctor! My grandmother is about 77 years old, and we recently discovered a hard lump at the inner end of her groin near her buttocks, approximately the size of a ping pong ball, which is immovable.
It feels very hard and differs from the elastic texture of a lipoma.
Initially, my family and I helped her clean her buttocks daily, and everything seemed normal until one day we suddenly noticed the lump.
It has been over a month since we discovered it, and it doesn't seem to have increased in size, or it may have only slightly enlarged.
Due to my grandmother's dementia and limited mobility, it is not convenient for her to visit a hospital.
Therefore, I would like to consult with you online regarding the following questions:
1.
Which specialty should my grandmother see for her condition?
2.
Regarding the hard lump or tumor in the mentioned area, what diseases are typically associated with it? Additionally, what are the usual procedures for handling this? (Is surgery required?)
3.
My family and I are considering applying for home healthcare to see if we can arrange for a doctor to visit first, and then proceed to the hospital for necessary treatments (if surgery is needed).
Can a home visit by a doctor provide an initial diagnosis of the hard lump under the skin, or would you recommend going directly to the hospital for an appointment?
Thank you for taking the time to read and respond!

Sally, 20~29 year old female. Ask Date: 2019/11/04

Dr. Ye Qianyu reply Family Medicine

Hello! In response to your questions:
1.
It is recommended that you schedule an appointment with a general surgeon, but depending on the hospital's specialty, you may need to see a colorectal surgeon.

2.
Whether the mass requires surgery depends on the underlying cause and your grandmother's level of dementia.
Based on your description, it could potentially be a localized hematoma, a muscle abscess, an anal abscess, or an anal fistula; tumors are also a possibility.
If active intervention is needed, aspiration or surgery will be necessary for diagnosis and treatment.

3.
Home healthcare will still incur some costs and transportation fees, but if the physician cannot make a diagnosis on-site or if a diagnosis is made but hospitalization is still recommended, it will depend on whether you and your family can accept that.
If you wish to pursue active treatment, it is advisable to go to the hospital.
Additionally, if there are accompanying symptoms such as redness, swelling, warmth, pain, fever, or loss of appetite, this may indicate an increased risk of infection, and I recommend taking your grandmother to see a doctor as soon as possible! Thank you for your inquiry.

Reply Date: 2019/11/04

More Info

Hello! Thank you for your inquiry regarding your grandmother's condition. It’s understandable to be concerned about a hard lump on her buttocks, especially given her age and health status. Let’s address your questions one by one.

1. Which Specialist Should Your Grandmother See?
Given the location of the lump on your grandmother's buttocks, it would be advisable to consult a dermatologist or a general surgeon. A dermatologist specializes in skin conditions and can evaluate the lump to determine if it is a benign skin lesion, such as a lipoma or cyst, or something that requires further investigation. A general surgeon can also assess the lump and determine if surgical intervention is necessary.

2. Possible Conditions and Management
The hard lump you described could be several things, including:
- Lipoma: A benign tumor made of fat tissue, typically soft and movable, but can sometimes feel firmer.

- Sebaceous Cyst: A common type of cyst that can feel firm and may be associated with a blocked sebaceous gland.

- Abscess: A collection of pus that can feel hard and painful, often requiring drainage.

- Fibroma: A benign tumor that can develop in connective tissue.

- Malignant Tumors: While less common, it’s important to rule out any cancerous growths, especially in older adults.

The management of these conditions varies. If the lump is benign and asymptomatic, it may not require immediate treatment. However, if it is painful, growing, or causing discomfort, surgical removal may be recommended. The process typically involves:
- Physical Examination: The doctor will assess the lump's size, texture, and any associated symptoms.

- Imaging: In some cases, an ultrasound or MRI may be ordered to get a better understanding of the lump's characteristics.

- Biopsy: If there is concern about malignancy, a biopsy may be performed to analyze the tissue.

- Surgical Intervention: If removal is necessary, it can often be done on an outpatient basis.

3. Home Healthcare and Initial Diagnosis
Regarding home healthcare, many regions offer home visit services where a healthcare professional can assess your grandmother's condition. A visiting physician can provide an initial evaluation of the lump, which may include a physical examination and a discussion of symptoms. However, they may not have the resources for imaging or more complex evaluations that a hospital setting can provide.

If the lump appears concerning or if there are any signs of infection (such as redness, warmth, or drainage), it is advisable to seek immediate medical attention. If home healthcare is an option, it could be a good first step, especially if transportation to a hospital is challenging.

Conclusion
In summary, I recommend consulting with a dermatologist or general surgeon to evaluate the lump on your grandmother's buttocks. While home healthcare can provide an initial assessment, a definitive diagnosis and treatment plan may require a visit to a medical facility. It’s essential to monitor any changes in the lump and your grandmother’s overall health. If you notice any new symptoms or changes, do not hesitate to seek medical advice promptly. Thank you for taking the time to care for your grandmother, and I wish you both the best in navigating this situation.

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