Subcutaneous Cysts: Causes, Removal, and Recurrence Concerns

Q: Subcutaneous Cysts: Causes, Removal, and Recurrence Concerns

Hello： In response to your question... <br>A subcutaneous tumor in a 25-year-old female is likely to be benign and should not pose a risk of metastasis. <br>If another lump has developed near the original incision, it could be due to incomplete excision or inflammation causing ed

Subcutaneous cysts

Hello Dr.
Ke: My friend recently underwent surgery at the hospital to remove a small tumor that had been growing on their buttock for nearly ten years.
The doctor explained that it was just a sebaceous cyst, and they are currently recovering after the removal.
However, in the past few days, they have noticed that another lump has started to form about 1 cm away from the excision site.
Is this type of tumor prone to metastasis? Could it have any negative effects? Will they need to have this new growth removed as well? Is this going to create an endless cycle of removal and regrowth? They had only that one cyst for over ten years, so they are quite confused as to why another one has appeared so soon after the surgery.
I apologize for taking up your valuable time, and thank you for your guidance.
Wishing you all the best!

Ms. S, 20~29 year old female. Ask Date: 2005/03/13

Dr. Ke Fangxu reply Surgery

Hello: In response to your question...
A subcutaneous tumor in a 25-year-old female is likely to be benign and should not pose a risk of metastasis.
If another lump has developed near the original incision, it could be due to incomplete excision or inflammation causing edema in the surrounding tissue, which may be mistaken for a recurrence.
Generally, it is advisable to wait until the wound has completely healed before further evaluation.
Additionally, how far is this tumor from the anal opening? Sometimes, an anal fistula can be misdiagnosed as a subcutaneous tumor.
Typically, surgical excision does not provide a cure, and it is necessary to seek evaluation from a colorectal surgeon.
Ministry of Health and Welfare, Keelung Hospital, Dr.
Ke Fang-Hsu.

Reply Date: 2005/03/13

More Info

Understanding subcutaneous cysts, particularly sebaceous cysts (also known as epidermoid cysts), is essential for both patients and healthcare providers. These cysts are benign, often filled with keratin, and can occur anywhere on the body, including the buttocks, as in your friend's case. They typically develop from blocked sebaceous glands or hair follicles and can remain asymptomatic for years, sometimes even decades, before becoming noticeable or bothersome.

Causes of Subcutaneous Cysts
The primary cause of subcutaneous cysts is the obstruction of sebaceous glands or hair follicles. Factors contributing to their development include:
1. Genetics: Some individuals may have a genetic predisposition to developing cysts.

2. Skin Trauma: Previous injuries or surgeries can lead to cyst formation.

3. Hormonal Changes: Hormonal fluctuations, especially during puberty, can increase oil production and lead to clogged glands.

4. Infections: In some cases, infections can cause cysts to form as the body attempts to isolate the infection.

Removal of Subcutaneous Cysts
When a cyst becomes bothersome, infected, or painful, surgical removal is often recommended. The procedure typically involves:
1. Local Anesthesia: The area around the cyst is numbed to minimize discomfort.

2. Incision and Drainage: The surgeon makes a small incision to remove the cyst and its contents.

3. Closure: The incision is then closed with sutures, and the area is bandaged.

Post-operative care is crucial for preventing infection and ensuring proper healing. Patients are usually advised to keep the area clean and dry and to monitor for any signs of infection, such as increased redness, swelling, or discharge.

Recurrence Concerns
It is not uncommon for new cysts to develop after the removal of an existing one. This can happen for several reasons:
1. Multiple Cysts: Some individuals are prone to developing multiple cysts over time, which may not be related to the previous cyst.

2. Incomplete Removal: If the cyst wall is not entirely removed during surgery, it can lead to recurrence.

3. New Blockages: New cysts can form due to ongoing blockages in nearby sebaceous glands or hair follicles.

In your friend's case, the appearance of a new cyst shortly after the removal of the previous one could be due to any of these factors. It is essential to consult with a healthcare provider to evaluate the new growth. They may recommend monitoring it for changes or performing another surgical procedure if it becomes symptomatic or bothersome.

Are Cysts Cancerous?
Subcutaneous cysts are generally benign and do not metastasize or spread like cancerous tumors. However, if there are concerns about the nature of the cyst, such as rapid growth, changes in color, or pain, it is crucial to seek medical advice. In rare cases, what appears to be a cyst could be a different type of lesion that requires further investigation.

Conclusion
In summary, while subcutaneous cysts are typically harmless, their recurrence can be frustrating for patients. Understanding the nature of these cysts, their causes, and the surgical removal process can help alleviate concerns. If your friend continues to experience new cyst formations, it is advisable to consult with a dermatologist or surgeon who can provide tailored advice and treatment options. Regular follow-up appointments may also be beneficial to monitor any new developments and ensure proper management.

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