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Lumps on legs, ultrasound showed edema in soft tissue, have hypothyroidism, had toxicity from Tegretol. Need help

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General & Family Physician
Practicing since : 2009
Answered : 983 Questions
NHello, I have 2 very large masses on the outsides of both legs, as well as a lump on the bottom of both feet near the heal. I have had an ultrasound recently that showed edema in the soft tissue, but my Dr then sent me to a hematologist/oncologist. That Dr told me I'm retaining fluids and take a water pill, BUT....these masses DO NOT go down, only keep growing! My legs/feet do not swell constantly, but they do a lot, however, the masses do NOT change! He then told me its from fibromyalgia, which I do have, but I do NOT trust what he's saying as he changed the answer 3 times within a total of a 5 minute consultation! I am very fatigued, and also having skin/hair changed as well. I am hypothyroid, but am talking 2 medications. My legs started swelling ab out 5 years ago after my intestines fell out about 4-5 inches, not just a prolapse. They did not go back in properly, which was confirmed by my GI Dr. Also, the front side of my legs are brown and red, but the backs are normal color. They havebeen like this for about 7 months or so. I am going through toxicity from Tegretol, which I am being weaned off of right now. However, this is just recently! I have had these masses on both legs for several months, approximately 6 months or so. My Dr sent me to the specialist saying that I have enlarged lymp nodes, but the specialist said I dont! I asked about infection, but he says my labs look great, but the labs he was looking at were for potassium/magnesium! I am hypokalemic and now having low magnesium on top of it. I am not an idiot, therfore I do not believe the specialist I had seen last week! I have had to do much research on my own, which in fact, that is how I found out that I have toxicity, which was confirmed by the prescribing physician the same day. I do know that lymphatic blockage can be caused by injury, which I did have a chiropractor displace my spinal cord 9 years ago, but 9 months later had surgery for, but then was told 2.5 years afterwards that they had done the wrong surgery, which caused further damage. As you can tell, I am in desperate need of help. I have 2 teenage daughters, 1 whom has XXXXXXX bleeding they the Dr's haven't been able to locate as well. I am very busy between Dr appointments for us, as well as travel almost 3,000 miles with my husband to The National Institutes of Health in Md for a drug trial for his Von Hipple Lundou. I desperately need help to get this takenen care of so I can help the rest of my family! I am not saying "poor me, or poor us", but I am asking PLEASE HELP ME! It seems like the Dr's that I have seen either don't know which direction to go in, or just plain do not care! Thank you for taking the time to read this, as well as for your help!
Posted Sat, 16 Jun 2012 in Bones, Muscles and Joints
Answered by Dr. Aparna Kohli 11 hours later
Thanks for writing in.
I understand your concern.
As far as the lumps in your legs and foot are concerned, I would request you to answer the following questions:
a. Does the size of the lump increase or decrease on its own? Have you noticed any changes when you rest or put your feet up?
b. Does the skin on your lump pit when you apply pressure on the skin overlying the lump (You would need to put pressure on the skin overlying the lump with your finger for 20 seconds and check whether a pit is produced)?
It would be great if you could send a picture of the lump. You can use the 'Upload your reports' section on the right.
Also, please upload whatever lab reports you have so that we have a fair idea of where to begin.
The lump can as such be caused by either water retention, infection, lymphatic blockage, a benign tumour or several other reasons.
If you could answer the questions above and provide me with the reports, I would be able to provide you a fair idea of what should be your next steps.
Awaiting your reply
Above answer was peer-reviewed by
Follow-up: Lumps on legs, ultrasound showed edema in soft tissue, have hypothyroidism, had toxicity from Tegretol. Need help 3 days later
Hello, regarding the swelling.....
The swelling will go down as my legs are resting, however, only part of the time there is fluid retention. I just had a staph culture taken 2 days ago and waiting in reports. I am going for a C-reactive protein test and a sedimentation rate as well. The pictures aren't very good, but I hope you can see the large whitish large mass on the side of the left leg, as well as the right. There is also another smaller mass on the front of my right leg as well. The masses are only growing, never go down. They do not indent when my legs are swollen, but they do feel kinda rubbery. My PCP look at them 2 days ago as well, and said my skin feels thick. I have been going throught this for a very long time, but it's getting worse here in the past 3 or so months. I hope this helps give you some answers and I can finally get the help that I am in desperate need of!

Thank you for your time : )
Answered by Dr. Aparna Kohli 5 hours later
Thanks for writing back.
In all probability, we are looking at some kind of water retention here. This can occur due to multiple causes, but as you have thickened skin, I would first like to rule out hypothyroidism. For this, you would need thyroid function tests like thyroid stimulating hormone levels, free thyroxine levels and free tri-iodothyronine levels. I would also want to have your serum albumin levels checked and have a look at your electrolytes. Since you say these tests have been done, it would be great if you can upload reports.
Hope this helps
Awaiting your reply
Above answer was peer-reviewed by
Follow-up: Lumps on legs, ultrasound showed edema in soft tissue, have hypothyroidism, had toxicity from Tegretol. Need help 1 hour later
Hello again,

I am hypothyroid, which I am currently taking levothyroxine and cytomel. I am taking both for help with mood. My electrolytes get wacky as well. My recent magnesium level came back low, therfore they said to double my dose. I have to take liquid potassium due to absorbtion issues. Please understand that I had NONE of these problems with my legs, until my intestines fell out! I have 2 lympomas removed previuosly, so I'm starting to wonder if there could be more. However, they did not show up on CT, MRI or XRAY when I was checked for the ones in the past. They had to do surgery in order to find them. The surgeon was amazed at the size because one was as big as the palm of his hand, but the mass did not show to be that large. I don't mean to sound rude, but these masses that are currently present do not go down when the rest of my leg swelling goes down! I know that there is some edema off and on, but these masses are growing to be very large. If it was just edema, the masses would go down with the rest of my leg, not grow! I know it is a lot more complex than edema, and the PCP says the masses are not edema as well. I will be more than willing to send copies of my labs, however I will not be going to get them done until tomorrow. I was not aware that a time issue with this, therfore, I guess the question will be closed by time I get the results back. Please try to look further into this because it's not edema. I'm not frustrated with you, but rather frustrated with this continuing to go on. They get to be painful and tired after a short time, therfor I am limited on what I can do. I have two teenage daughters that I should be shopping with, not having to sit in bed resting my legs!
Thank you for your reply and I will upload lab results after I get them back. If you have any firther questions that I am able to answer, I'd be more than willing!

Thank you for your time : )
Answered by Dr. Aparna Kohli 1 hour later
Thanks for writing back.
I understand your concern and agree that we need to address this as aggressively as possible. Thank you for providing this history. It puts everything in a new perspective. As far as the oedema in the legs is concerned, I think we should be doing the labs again on your thyroid issues and managing them more aggressively. As far as the masses are concerned, I think an ultrasound of the lump and maybe a fine needle aspiration cytology should be the way ahead. If they are distinct lumps, I think you should be seeing your surgeon to take this forward. We can then be looking at different causes ranging from a benign tumour to a malignant one.
This query remains active for 72 hours. If your labs come back later than that and if you still wish to discuss them, I think you can recharge this query and continue with the follow up.
Hope this helps. Let me know if I can be of more assistance.
Above answer was peer-reviewed by
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