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Hard, movable lump on left clavicle. Primary doctor says sebaceous cyst. Endocrinologist sending to surgeon. Any idea?

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Practicing since : 1980
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I discovered a hard, movable lump on my left clavical 1/2 way to my sternum. My primary doc thinks it to be a sebacious cyst, but my endocrinologist said no and is sending me to a surgeon to get looked at. I'm 50, no family history of cancer, but I'm overweight, am a type 2 diabetic with hypertension and hypothyroidism. I have the appointment with the surgeon on Tuesday, but I hate the anxiety of waiting...
Posted Sun, 15 Apr 2012 in Cancer
Answered by Dr. Rajinder Bajoria 24 hours later
Thanks for the query .

Possibility of sebaceous cyst can't be ruled out completely ,because sebaceous cysts are seen at this site ,but chances of sebaceous cyst are quite less in this region.

Sebaceous cyst has punctum in the centre of lump ,that can be clearly seen .

Any hard lump in the left clavicle region is always seen with suspicion ,as it is the well known site for metastasis.

So proper examination ,followed by biopsy is must in such cases.

Chances of lymph node enlargement simply due to some infection can also be there ,as you are a known diabetic .

Hypertension & hypothyroidism has nothing to do with this swelling.

So your endocrinologist is right in referring you to surgeon.

FNAC (fine needle aspiration cytology) or excision biopsy can only help in reaching the diagnosis.

Hope I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.

Dr .Bajoria

Above answer was peer-reviewed by
Follow-up: Hard, movable lump on left clavicle. Primary doctor says sebaceous cyst. Endocrinologist sending to surgeon. Any idea? 3 hours later
Does the fact that it is a movable lump as opposed to stationary make it less possible that it is a metastasis?
Answered by Dr. Rajinder Bajoria 25 hours later

Thanks for writing again.
In case of mobile lymph nodes, chances of malignancy or metastasis is less. But in early stage even metastatic lymph nodes may be mobile.

So final diagnosis rest with FNAC or excision biopsy.

The left supraclavicular lymph node is known as Virchows lymph node.

Virchow's node receives the lymph drainage from most parts of the body (especially the abdomen) via the thoracic duct and is thus an early site of metastasis for various malignancies. This is just to educate you. Do not jump to any conclusions without physical examination and relevant tests.

Hope, I have answered your query.

Wish you good health.

Above answer was peer-reviewed by
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