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Having chest pain with painful lump on it. What could this be?

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General & Family Physician
Practicing since : 2009
Answered : 8985 Questions
My fiance has an XXXXXXX lump in the center of his chest above his stomach. When pressure is applied to the lump it is painful and today he is having general chest pain where the lump is located. He has had this lump for almost 6 months toa year. what could this be?
Posted Wed, 17 Apr 2013 in Lung and Chest disorders
Answered by Dr. Shoaib Khan 4 hours later
Hello and welcome to XXXXXXX

Thank you for writing to us.

From your description of the location (which is an important factor here) I am assuming the lump on your fiance's chest is near the sternum (a flat bone located at the middle of the rib cage). A lump located near the sternum is a very common complaint, but it is most often absolutely nothing to worry about. Let me explain both the normal occurrences of this lump as well the abnormal ones which might require treatment.

In majority of cases, a lump on the sternum is a 'naturally' occurring protrusion on the sternum called the xiphoid process. This is a combination of bone and cartilage that is located at the bottom of the sternum, usually close to the center of the rib cage. Most individuals do not notice this bony protrusion early, and when they do finally notice it, they are concerned about it being something abnormal. Some individuals have a more protruding xiphoid process than others which might look like a lump under the skin. This will also pain when pressure is applied as it is attached to the sternum only with the help of cartilages, and when pressure is applied this will pain and might even get dislocated.

On rare occasions however a lump in that region can be caused by a cyst, tumor or a hernia. The treatment for each of these will depend entirely on the location and severity.

Hernias occur when a small amount of fatty tissue or a part of the intestines protrude from an opening in the bones. Small hernias do not require any treatment, but larger ones are usually surgically corrected.

Tumors whether cancerous or non-cancerous need to be surgically removed, unless a non-cancerous tumor is very small (in this case, no treatment is required).

A cyst if simple and uncomplicated is usually left without treatment; whereas a complicated one is usually surgically removed.

Now as your fiance also experiences pain when pressure is applied on the lump and even has general chest pain, this might require attention from a doctor. If you wish to rule out all abnormal conditions the lump will first have to be physically examined by a doctor and you could then go for laboratory analysis of the lump tissue. This will be required to make a diagnosis as all causes mentioned above will present in the same way. Please do not worry, and take your fiance to a doctor, who will surely diagnose your fiance's condition.

In the meantime, please avoid applying pressure to this region, as even if it is normal, continuous pressure can cause irritation and thus result in pain.

I hope you found my response helpful and informative. Do write back to me for any further clarifications, I would be happy to help you.

Best wishes.
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