Groin Lumps: Causes, Concerns, and Treatment Options

Inguinal mass

My wife is 37 years old and has developed a hard lump near the groin area close to the vulva.
About two to three years ago, it was roughly the size of a red bean and was palpable, but it was not painful when pressed.
Last year, it grew to the size of a small fingertip.
Initially, she consulted an oncologist who suggested that it might be lymphadenopathy due to gynecological inflammation.
After prescribing anti-inflammatory medication, she was referred to a gynecologist for further monitoring.
After using a suppository for a week, the lump slightly decreased in size, but not significantly.
The gynecologist performed a Pap smear and noted cervical inflammation, recommending continued observation with suppositories.
During a follow-up six months later, the lump had regrown, and it was still not painful upon palpation.
The gynecologist suggested surgical excision and biopsy.
The surgery was performed last Friday, and the doctor informed my wife that the lump was relatively hard and the size of a small fingertip.
Based on this description, what could be the cause of the tumor? Is there a significant possibility that it could be malignant? Thank you for your clarification.

Niming, 30~39 year old female. Ask Date: 2019/11/05

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you will undergo surgery for excision on Friday.
We will wait for the pathology report.
Generally, the likelihood of malignancy is very low, so there is no need to worry.
Wishing you good health.

Reply Date: 2019/11/05

More Info

Understanding groin lumps can be a complex issue, as there are various potential causes, ranging from benign to malignant conditions. Based on your description, your wife has experienced a hard lump in the groin area that has grown over the past few years, initially diagnosed as likely related to lymphadenopathy due to inflammation. The fact that the lump has been present for a couple of years, has increased in size, and is not painful upon palpation provides some clues regarding its nature.

Possible Causes of Groin Lumps
1. Lymphadenopathy: The most common cause of lumps in the groin area is swollen lymph nodes, which can occur due to infections (like sexually transmitted infections, or STIs), inflammatory conditions, or malignancies. In your wife's case, the initial assessment suggested that the lump could be due to inflammation, which aligns with lymphadenopathy.

2. Sebaceous Cysts: These are benign lumps that can occur in the skin and are often painless. They can become inflamed or infected, leading to changes in size and tenderness.

3. Lipomas: These are benign tumors made of fat tissue. They are generally soft, movable, and painless, but can sometimes feel firm depending on their location.

4. Abscesses: If there was an infection, an abscess could form, which would typically be painful and swollen. However, since your wife’s lump is not painful, this is less likely.

5. Malignant Tumors: While the possibility of malignancy cannot be ruled out, especially given the lump's growth and firmness, it is essential to consider that many lumps in the groin are benign. However, the characteristics of the lump, such as its hardness and growth pattern, warrant further investigation through a biopsy, which is what the surgeon has recommended.

Concerns and Next Steps
The fact that the lump has grown and is firm raises some concerns, and the recommendation for surgical excision and biopsy is a prudent step. A biopsy will provide definitive information regarding the nature of the lump, whether it is benign or malignant.

Malignancy Risk
The risk of malignancy depends on several factors, including the characteristics of the lump (size, consistency, growth rate), associated symptoms (such as weight loss, fever, or night sweats), and the patient's medical history. Given that the lump has been present for a significant period and has changed in size, it is wise to proceed with the biopsy to rule out any serious conditions.

Post-Surgery Considerations
After the surgical removal and biopsy, the results will guide the next steps. If the lump is benign, the doctor may recommend monitoring. If it is malignant, further treatment options, such as additional surgery, radiation, or chemotherapy, may be necessary.

Conclusion
In summary, while the lump in your wife's groin could be due to several benign causes, the growth and firmness are concerning enough to warrant further investigation. The surgical excision and biopsy will provide clarity on the diagnosis. It is essential to follow up with the healthcare provider for the results and any necessary treatment plans. In the meantime, maintaining open communication with the medical team and addressing any new symptoms or concerns is crucial for your wife's health and peace of mind.

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