Assessing the Malignancy Risk of a Small Groin Lump: What You Need to Know

Is there a possibility of malignancy?

There is a small, painless lump about 1 cm in size on the left side of my groin, which is not visible externally and can only be felt with some pressure.
When I first discovered it, it felt firm and slightly mobile, so I decided to monitor it.
In mid-June of last year, due to weight loss and other physical discomforts, I sought medical advice from various departments at a large hospital to find the cause.
In June, July, and December of last year, my family physician, hematologist, and general surgeon examined the lump through palpation.
The family physician ordered an LDH blood test, which returned normal values, leading them to believe it was unrelated to lymphoma.
The hematologist noted that the lump felt small, firm, and mobile, indicating it was likely benign, and also ordered an LDH test, which was normal.
The general surgeon identified it as a lymph node but, based on my description, felt it did not resemble the clinical presentation of malignant lymphoma and advised me to continue monitoring it.
However, I recently realized that I had misremembered the timeline during my visits, stating that this small lymph node had been present since the end of 2021, when in fact I believe I only felt it around March to April of 2022.
Could this miscommunication have led to a misjudgment by the doctors? (This lymph node has not changed in size since April of last year.) Additionally, upon further reflection, it seems that prior to discovering this small lymph node, my left groin area had once been swollen, which I attributed to weight gain, thinking it was a lump of fatty tissue (as it was located at the edge of my underwear, I assumed it was due to being slightly overweight and prolonged sitting).
At that time, I felt it was soft when I pinched it, so I did not think much of it.
Later, this lump of "fat" seemed to disappear without my noticing (or perhaps I lost weight), and I only felt this 1 cm painless lump in the same location.

I would like to know, given that there was a prior swelling that disappeared, leaving behind this small 1 cm lump, what is the likelihood that it is malignant?

Mi Mi, 40~49 year old female. Ask Date: 2023/01/05

Dr. Chen Sirong reply Oncology

Mimi / 42 years old / Female would like to ask about the appearance of a swelling that initially enlarged and then disappeared, leaving a small 1 cm lump.
Is there a significant possibility of malignancy? A: 1.
All previous doctors have examined it.
2.
Blood tests at that time were normal.
3.
It appears that further observation is feasible.
4.
If there is no increase in size, hardness, or change in color, a follow-up with a physician for reassessment is recommended.
Wishing you a Happy New Year, Taoyuan Hospital, Dr.
Chen Si-Rong.

Reply Date: 2023/01/05

More Info

When assessing the malignancy risk of a small groin lump, several factors must be considered, including the characteristics of the lump, associated symptoms, and the clinical history. In your case, you have described a 1 cm painless lump in the left groin that feels somewhat mobile and has remained stable in size since its discovery. This is an important detail, as stability in size over time can often be a reassuring sign.

The fact that multiple healthcare providers have examined the lump and found it to be consistent with a lymph node, along with normal laboratory results (such as LDH levels), suggests that there may be a lower likelihood of malignancy. Typically, malignant lymph nodes are associated with characteristics such as firmness, immobility, and rapid growth, which do not seem to apply to your situation. Additionally, the normal LDH levels further reduce the suspicion of hematological malignancies, such as lymphoma.

You mentioned that the lump has been present since around March or April 2022, and it has not changed in size since then. This chronicity, combined with the lack of pain and the described texture, is generally more indicative of a benign process. Common benign causes of lymphadenopathy in the groin include reactive lymph nodes due to infections or inflammation, lipomas (benign fatty tumors), or other non-cancerous growths.

The previous swelling you experienced in the same area that later resolved could indicate a transient inflammatory process, which is not uncommon. Lymph nodes can enlarge in response to infections or other stimuli and may return to normal size once the underlying issue resolves. The fact that you initially misidentified the lump as fatty tissue could also suggest that it is benign, as malignant tumors typically do not have the soft, mobile characteristics you described.

However, it is crucial to remain vigilant. While the current assessment leans towards a benign interpretation, any persistent lump should be monitored. If there are any changes in size, texture, or associated symptoms (such as pain, fever, or unexplained weight loss), further evaluation may be warranted. In such cases, imaging studies like an ultrasound or CT scan can provide additional information about the lump's characteristics and help determine if a biopsy is necessary.

In summary, based on the information provided, the likelihood of malignancy appears low, especially given the stability of the lump, the normal laboratory findings, and the assessments by multiple physicians. However, continued observation is essential, and if there are any new developments or concerns, a follow-up with a healthcare provider is recommended. Regular monitoring and communication with your healthcare team will ensure that any changes are addressed promptly.

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