Hard Lumps on the Head: When to Seek Medical Advice

Hard lump on the scalp?

Hello, Doctor.
Since last October, I have noticed a hard lump on the top of my head, measuring a little over one centimeter in diameter.
It is round, very hard, immobile, and not very painful.
In February of this year, I visited a surgeon who examined it and suggested it might be a bone tumor.
He mentioned that it was too small to be clearly seen on imaging and advised me to return if it grew larger.
In March, I consulted a private neurosurgeon who also suspected it could be a bone tumor.
After performing an MRI, he stated that nothing significant was found and advised that if there were no changes, I should not worry about it.
Now, nearly five months later, I feel that the lump may have grown slightly.
Should I go back to see a doctor? Is it possible that the lump is indeed a tumor? Which specialty should I consult?

juno, 20~29 year old female. Ask Date: 2015/07/13

Dr. Ding Xianwei reply Neurosurgery

It is recommended that you follow up at the neurosurgery outpatient clinic.

Reply Date: 2015/07/13

More Info

When it comes to hard lumps on the head, particularly those that have been present for several months, it is essential to approach the situation with caution and seek medical advice. Based on your description, you have a hard lump on your scalp that has been present since October of last year, and while it has been evaluated by both a general surgeon and a neurosurgeon, there are still concerns about its nature and potential growth.

Firstly, it is important to understand that not all hard lumps on the head are indicative of tumors. Many benign conditions can present as hard lumps, such as lipomas (fatty tumors), sebaceous cysts, or even bony growths like exostoses. However, the fact that your lump has been described as hard, immovable, and slightly increasing in size warrants further investigation.

The initial assessments you received, including physical examinations and imaging studies like MRI, are crucial first steps in evaluating the lump. The fact that both specialists suggested it could be a bone tumor but did not find conclusive evidence on imaging is somewhat reassuring, but it does not eliminate the need for ongoing monitoring. Bone tumors can be benign or malignant, and while many are not life-threatening, they can still cause complications depending on their location and growth.

Given that you have noticed a slight increase in size, it would be prudent to return to a healthcare provider for a follow-up evaluation. You should consider consulting with a neurosurgeon or an orthopedic surgeon specializing in bone tumors. They may recommend further imaging studies, such as a CT scan or a repeat MRI, to get a clearer picture of the lump's characteristics and to assess any changes since your last evaluation.

Additionally, if you experience any new symptoms—such as pain, headaches, neurological changes (like numbness or weakness), or changes in vision—these should be reported to your doctor immediately, as they could indicate a more serious condition.

In summary, while the lump may not be a cause for immediate alarm, the increase in size and the duration of its presence suggest that further evaluation is warranted. It is always better to err on the side of caution when it comes to potential tumors. Regular follow-ups with the appropriate specialists will ensure that any changes are monitored and addressed promptly. Your health and peace of mind are paramount, so do not hesitate to seek further medical advice.

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