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Painless lump and cramps on the leg. No tingling, numbness, lesion. Why am i getting this?

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I noticed a small, painless lump (that is about the size of a pea) under the skin of my left calf
At first I thought it was an insect bite, but it's not red and it doesn't itch. The lump is under the skin, and located on the muscle (near the base of the muscle that is defined ) of the left calf. I don't feel any tingling, numbness, or warmth in that spot. When I press on the lump it feels firm but it doesn't hurt. There are no lesions or sores on the surface of the skin in that place; just a bump. In the past I have gotten night cramps in both calves when stretching my legs upon waking or in the middle of the night.
Posted Tue, 8 May 2012 in Skin Hair and Nails
Answered by Dr. Radhika 1 hour later
Thanks for the query.

You have provided me with good information.
You have noticed a painless lump which is the size of a pea under the skin of your left calf.
There are many possible causes for it which include:
• Skin cysts
• Cherryangioma
• Dermatofibromas
• Epidermoid cysts
• Folliculitis
• Keratoacanthoma
Keratosis pilaris
• Lipomas
• Neurofibromas.

Lumps can be caused by any number of conditions, including infections, inflammation, tumors and trauma. Depending on the cause, lumps may be single or multiple, soft or firm, painful or painless. They may grow rapidly or may not change in size.
Lumps due to infectious causes in or near your leg may appear as boils or abscesses.

There is a probability it might be a Lipoma. Lipoma is a lump or mass that is made up of fat cells (adipocytes). Lipomas are a common, benign (noncancerous) type of slow-growing tumor. They most often develop just under the skin in the subcutaneous tissue, located beneath the skin and above the muscle.

There are rare causes, it could be due to malignant tumors of the skin, soft tissues, or bones can appear as lumps on the thigh. In these cases, either a biopsy or surgical removal of the lump can determine whether cancer is present.

You also have night cramps in your legs, for this you need to get examined by a Physician for muscular aches, Thrombosis, anemia etc.

Do not worry, it is highly unlikely to be malignant.

I hope I have answered your query. Please accept my answer if you have no follow up queries.

Above answer was peer-reviewed by
Follow-up: Painless lump and cramps on the leg. No tingling, numbness, lesion. Why am i getting this? 2 hours later
Thank you for getting back to me. Just FYI, the night cramps only happen occasionally (the last one was several weeks ago) if I stretch my legs too rapidly or too suddenly upon awakening. The cramp lasts only momentarily subsides once the muscle relaxes.
Answered by Dr. Radhika 14 hours later
Thanks for the follow up.

Night cramps most of the time occur for no known reason, and they're harmless.

Sometimes, it can be due to dehydration, muscle fatigue or electrolyte abnormalities. It is better to drink sufficient fluid and also see that your intake of electrolytes (sodium, potassium, magnesium ) is sufficient. .You can drink Oralyte for this.

I hope I have answered your query. Please accept my answer if you have no follow up queries.

Above answer was peer-reviewed by
Follow-up: Painless lump and cramps on the leg. No tingling, numbness, lesion. Why am i getting this? 12 days later
Hello Doctor XXXXXXX

Since I last sent you my follow-up comment, I went to see a physician. I forgot to mention before that I have been living and working in South Korea since 2009.

For the past four months I have been receiving treatment at a skin clinic in Seoul. The doctor there is very good and speaks English. I recently had a small abnormality removed from the surface of my left XXXXXXX Apparently it was an old abrasion that had not healed properly. The doctor applied liquid nitrogen to freeze it off and over the past few months the area has healed, leaving just a tiny scar.

I went to see the doctor on 1/14 for follow-up and while I was there I showed him the aforementioned, subcutaneous lump on my left calf. His assessment was that it's not Lipoma because of the degree of firmness. He suggested that I have it removed and a biopsy performed to rule out any malignancy. He added, however, that he felt it is benign. He said that after the excision I might require plastic surgery to reduce the appearance of the resulting scar.

I won't be able to have anything done until late February. He had told me not to worry, but I am worried nonetheless. The area where the lump is located is a bit sore (when I press on it); but I think that's from the doctor pinching the skin there between his fingers in order to feel the lump.

I was examining my right calf this morning and I felt a smaller lump (about maybe 1/3 the size of the other one) Near that area I noticed a small, protruding vein near the surface of the skin. It does not appear to be of an abnormal color and it is not painful... neither is the lump.

On an unrelated note... on 1/13 I noticed some inflammation on the smaller toes of my right foot. This was accompanied by some slight itching. The next morning while showering I felt some tenderness on the underside of the two last, smallest toes and during the day I experienced discomfort while walking. When I returned home I removed my shoes and socks and discovered a small blister on the underside area between those two toes. The blister had apparently ruptured because there was a small amount of dried blood on the inside toe of the right sock.

I soaked both feet in a tub of warm water and borax soap, then rinsed and dried them. The top part of the foot was itching slightly so I applied both some anti-itch ointment and some antibiotic ointment to the affected areas. Then I put on clean socks and took two Acetominiphen caplets. After soaking my foot, the tenderness was not as noticeable. At this writing it has lessened, although there is still a slight itching on the top part of the foot, near the toes.

Now, this had happened to me before... during the Thanksgiving weekend; only it was the left foot that had been affected. On that foot, however, there had been no blister... just itching and inflammation. Part of the reason for it, I think, was that at that time I was wearing a new pair of athletic hiking shoes. I think the left shoe had been creating undue pressure against the smallest toe; pressing it up against the adjacent toe.

When I press on the top of my right foot, near the toes, there is still some soreness; but, as I said before, it seems lessened from the previous day.

In addition to all of the above; I noticed two days ago that I have some inflammation in my right knee. I remember that, earlier in the week I had bumped my knee on the underside of a desk as I was getting up out of my chair. The area I had bumped is located just above the knee joint where it attaches to the thigh, It's still a little sore if I press on the area and there's a slight bruising. The inflammation I'm also experiencing, however, is off to the side of the kneecap and feels like it's in the muscle or tendon just below the skin. Occasionally when sitting or walking I experience a moderate pinching sensation in that area. I'm not sure what can be the cause. The discomfort is mild, occasional but nevertheless noticeable.

Sorry for the length of this follow up question... but I am concerned. I'm also worried that when I eventually have the lump removed from my left calf that it might be something serious. It does not appear to have changed in size since I first noticed it.
Answered by Dr. Radhika 20 hours later
Thanks for the follow up.

You have provided me with good information.

It is good that you have consulted your physician. It is always advisable to have a biopsy of the lump so that the exact nature of the lump can be determined. In all likelihood, the lump would be benign and I would like to reassure you that you needn’t worry.

It is better if the other lump present in the right calf also be examined and sent for biopsy .Even though the colour is normal or painless, it should be proved benign.

You also have itching with blister formation in your right toes which normally does happen after you wear new shoes. Continue to apply the antibiotic cream or Neosporin and do soak the feet in warm water mixes with salt. Use socks and moisturizing lotion on your feet before using new shoes.

As you have hurt yourself in your right knee, there will be bruising and pain for more than a week. You should apply hot compresses 3 to 4 times daily and elevate the region. If the pain is too much, you can take Tablet Tylenol twice daily 200 mg for 3 days.

Do not worry about the lump being malignant and it is benign unless proved otherwise.
I hope I have answered your query. Please accept my answer if you have no follow up queries.

Above answer was peer-reviewed by
Follow-up: Painless lump and cramps on the leg. No tingling, numbness, lesion. Why am i getting this? 44 hours later
Thank you for getting back to me. I went to see my doctor at the local clinic in my town and I reported to him what both you and the doctor at the skin clinic had told me.

He took a pen and marked the edges of where the lump on the left calf is located and then measured it as being one centimeter in length. He suggests that it could be a lump of fibrous tissue and doesn't recommend having it excised unless it gets bigger. His assessment is that whatever it is it is either slow-growing or may reduce in size.

I wanted to report that the inflammation on top of my right foot, just above the toes, is lessened. I have continued to apply moist heat and Neosporin to the area where the blister occurred. There is a pocket of dead skin on that area, but I think eventually it will peel off on it's own.

I was out walking yesterday and I may have irritated my right knee a bit. In the evening I noticed it was a bit sore, so I applied moist heat to it and then slept with a heating pad overnight. The inflammation is less noticeable today.

I do notice, however, that I have a slight tingling sensation in my calves, ankles, and feet. I am NOT experiencing any numbness where I can't feel sensations like touch (lightly pricking with a closed ball-point pen, pinching the skin) or hot/cold.

I have had lower back problems in the past and it was suggested that I may have Sciatica. I have experienced similar tingling in the past and I think it may have had to do with a pinched nerve.

However, because I now have the small lump in my left calf... I'm concerned that maybe the two might be connected, somehow. I can feel the lump press into the calf muscle if I press on it with my finger. There is a slight discoloration (redness) on the surface of skin in that spot. It appears to be a bruise from having been pinched so much between Saturday and today.
Answered by Dr. Radhika 1 hour later
Thanks for the follow up.

It is good that you got the second lump examined. You should certainly observe the rate of growth of the lump. The faster growing ones are malignant. Till you get the report of the first lump we can wait and watch.If the report is favorable we can expect even this to be fine. Else we have to get both examined.

The blisters in your leg will get cured in due time, keep applying Neosprin and use Vaseline whenever you wear shoes.

You are also having history of back pain with tingling sensation. Sciatica is caused by irritation of the sciatic nerve. The sciatic nerve can be pinched or stretched.
A herniated disc (slipped disc)is the most common cause of sciatica.

Discs are like cushions between the bones in the back. They act like shock absorbers when we move, bend, and lift. There is a tough ring around the outside and a thick jellylike center inside. If the outer edge of the disc ruptures, the center can push through and put pressure on the sciatic nerve, leading to the pain of sciatica. It is not seen anywhere than a lump can cause Sciatica.

You can send the picture of the lump to me at YYYY@YYYY with Subject:ATTN Dr. Radhika XXXXXXX

Awaiting your reply. I will be available for follow up queries, if any.

Above answer was peer-reviewed by
Follow-up: Painless lump and cramps on the leg. No tingling, numbness, lesion. Why am i getting this? 2 hours later

I should clarify my earlier follow-up statement:

When I went to see my local doctor on Monday, I showed him the FIRST lump; the one I had noticed in my left calf on January 2 and that I had written to you about. It was this same lump that I had subsequently shown to the doctor at the skin clinic this past Saturday. The doctor at the skin clinic had examined that lump and his assessment was that it is benign and that I shouldn't worry too much about it. He had recommended, though, that I get it removed and examined. At that time I had not discovered the smaller, softer lump in my right calf.

On Monday I went to see my local doctor and it was the lump on my left calf that he had marked with a pen and measured as being one centimeter in length. Again, he had recommended that I not get it removed unless it started increasing in size. He also examined my right calf. On the right calf is a slightly-protruding blood vessel and just maybe a fraction of a centimeter above that, I can feel with the tip of my finger a smaller (less than 1/4 centimeter), softer subcutaneous lump.

So I'm a bit confused... one doctor suggests having the first lump excised and another doctor says wait and see. If I were to wait until it got bigger, wouldn't it be too late by then to do anything about it? If it were something malignant, just how fast would it grow? Are we talking about a period of days, weeks, or months?
Attached are two photos I took of my left and right calves, just a few minutes ago. I am pinching the lump in the left calf by the edges. I measured it myself and it is actually just under one centimeter in length.

In the first photo you can see that there is a slight bruise on the surface of the skin and it is slightly sore from being pinched. It's only sore to the touch, otherwise it's not noticeable. You can also see that there is also a small mole on the calf just below where the lump is located.

In the second photo, the lump in my right calf is difficult to find and cannot be grasped between the fingers. If I run the tip of my finger over the area that is marked in pen I can feel it. Be advised, though, that the circle (which itself measures less than half a centimeter) does not represent the actual size of the lump, which is much smaller. Any protrusion you see on the right calf is actually that of a bulging vein.

It was difficult taking photos that are any clearer than this, sorry!
Answered by Dr. Radhika 1 hour later
Thanks for the follow up.
I have seen both the pictures.
The exact nature of the lump can only be definitely determined by a histopathological examination which can be done after a biopsy has been taken. If you wish to be absolutely sure of the same immediately, I would suggest that you get a biopsy done and get the matter done with.
It is difficult to predict the rate of growth of a malignant tumour as it depends on various factors. A more accurate prediction can be made if a biopsy is taken and the sample is examined under a microscope.
I would suggest that you closely observe both lumps for change in size, shape, texture, colour and consistency.
If you think there is a change in any of the above features, please consult your physician who can then perform a biopsy and come to a conclusive diagnosis.
I hope I have answered your query. Please accept my answer of you have no further queries
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