Subcutaneous fibroma, incomplete excision leading to residual adhesion and pain?
Hello Dr.
Li, I have a growth on my nipple that is the size of a thumbprint, which was diagnosed by a doctor as a subcutaneous fibroma (a type of pimple).
It has enlarged, and I underwent a surgical excision targeting the larger portion, but the excision was not complete, and it has re-adhered.
Recently, the re-adhered growth has been causing intermittent sharp pain.
I would like to ask Dr.
Li if I should return to the hospital for further evaluation, or if this could lead to other symptoms? Thank you for your help.
momo, 30~39 year old female. Ask Date: 2016/02/17
Dr. Li Zhonghuai reply Surgery
Hello! Is it a subcutaneous fibroma or a sebaceous cyst? Has it enlarged? Was the excision performed only on the larger portion? Is it because the excision was incomplete? What does incomplete excision mean? Please return to the original hospital and discuss with your physician.
Changhua Hospital cares about you!
Reply Date: 2016/02/17
More Info
Post-surgery pain from incomplete removal of subcutaneous fibromas can be a concerning issue, especially when symptoms such as intermittent stabbing pain arise. In your case, it seems that the initial surgical procedure did not fully excise the fibroma, leading to a recurrence of symptoms. This situation warrants careful consideration and follow-up with your healthcare provider.
Firstly, it is essential to understand what subcutaneous fibromas are. These benign tumors, often referred to as dermatofibromas, are typically small, firm nodules that can develop in the skin. They are usually harmless but can become symptomatic if they grow larger or if they are not completely removed during surgery. Incomplete removal can lead to residual tissue that may cause discomfort or pain, as you are experiencing.
The intermittent stabbing pain you describe could be due to several factors. It might be related to the irritation of the surrounding tissue, inflammation, or even nerve involvement if the fibroma is pressing against nearby nerves. Additionally, if the fibroma has reattached or formed new tissue, it could also contribute to the discomfort.
Given your symptoms, it is advisable to return to your healthcare provider for a thorough evaluation. They may perform a physical examination and possibly imaging studies to assess the area and determine if there is any residual fibromatous tissue that needs to be addressed. It is crucial to rule out any other potential complications, such as infection or the development of other types of lesions.
In terms of management, if the diagnosis confirms that there is indeed residual fibromatous tissue causing your symptoms, your doctor may recommend a second surgical intervention to remove the remaining fibroma completely. This procedure may involve a more extensive excision to ensure that all fibrous tissue is removed, thereby reducing the risk of recurrence and alleviating your pain.
In the meantime, to manage your pain, over-the-counter pain relievers such as acetaminophen or ibuprofen may be helpful. However, it is essential to consult with your doctor before taking any medication, especially if you have any underlying health conditions or are taking other medications.
Additionally, if you experience any signs of infection, such as increased redness, swelling, warmth, or discharge from the surgical site, you should seek medical attention promptly. These symptoms could indicate a complication that requires immediate treatment.
In summary, your symptoms following the incomplete removal of a subcutaneous fibroma warrant further evaluation by your healthcare provider. They will be able to assess the situation accurately and recommend the appropriate course of action, whether it be further surgical intervention or other management strategies. It is always better to err on the side of caution when it comes to post-surgical symptoms, as timely intervention can prevent more significant issues down the line.
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