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Noticed lump on back. Feels sensitive and swollen. Having pain. Concerned about cancer?

Answered by
Dr.
Dr. Rahul Kumar

Dermatologist

Practicing since :2010

Answered : 6300 Questions

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Posted on Tue, 27 Aug 2013 in Cancer
Question: Hi, i have just discovered this biggish lump on my lower half of my back. Part of it is just left of my spine and part on top of my spine. It feels quite sensitive and "swollen". If i sit back against my back it feels tender. Ive been having lower back pain all week. I was busy rubbing my lower back coz it was feeling tender and felt this lump. Its not itchy or red. Its about about 3cm wide and about 5cm long. I have attached photos.
I really concerned that it could be a tumour of some sort. Would you be able to assist with this please? Ive got 3 photos. Im not allergic to anything and as far as I knoe noghjng has bitten me. Please can you provide me with detailed answers as i have paid for this service. Thank you
doctor
Answered by Dr. Rahul Kumar 47 minutes later
Hello,
Thanks for the query.
I saw all the photographs.

At present I have following differential diagnosis.
1. Sebaceous cyst, which is a cyst containing cheesy material.
2. A deep bacterial abscess.
3. Neurofibroma, which is a tumor.

I would like to know the following additional points in order to reach to a closer diagnosis.

1. Since when you have this lump ?
2. Is the skin over the lump pinchable?
3. Does the lump move or is it fixed?
4. Ask someone to look closely and see if there is a black dot like opening in the centre of lump, I could see one but its not that clear.
5. On pressure do you feel any white material coming out from the lesion.
6. Do you have fever or had fever in recent past ?
7. Do you have extra skin growth like lesions else where on body?

Please answer the above questions so I can help you in a better way.

Waiting for your response.
Thank you.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Kumar 58 minutes later
1. Since today as far as I know as I have not felt it or seen it until earlier today.
2. I would have to say that the skin is not really loose and therefore not really pinchable. It feels swollen up and therefore feels stretched out.
3. The lump does not really move its more fixed bit not rock hard.
4. My husband had a look and could not see any black dot.
5. Also there is also no white material coming out
6. As far as I knoe i have not experienced fever in the recent past.
7. I dont have any extra skin growth like lesions. Ive only for a fissure that Ive had for a few weeks now.
Can you please tell me what it is more likely to be now please and any additional information would be much appreciated as I am concerned? Thank you
doctor
Answered by Dr. Rahul Kumar 38 minutes later
Hello,
Thanks for the reply.
With all the details it is looking like a sebaceous cyst,

The main concern is tumor, which can be ruled out on the basis of fixity.

It is fixed that means it is arising from skin and not the spinal cord.
Second thing is there is no neurological deficit,
Hence you can relax that it is not XXXXXXX

Even then I advice you to get an ultrasound of the lesion,
This can let you know the content of the lesion.

If it turns out to be a cyst it can be drained.

Let me know if you have any other doubts.

Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Kumar 26 minutes later
Hi Doctor, thank you for getting back to me. I would just like to confirm, in my first email i mentioned about having lower back pain all week.
1. Would this not be related then and be considered a neurological deficit? I just want to make sure its not associated.
2. Also as mentioned before the lump area is sensitive and experience medium discomfort when I sit against seat with my back? So this is also no concern then?
3. As you mentioned that its possibly a cyst? Would this type of cyst be different to one you would have in your breast? As Ive got one in my breast which is movable and rounder and doesnt seem to be anything like this lump?
4. I just tried to pinch the skin on top of the area again and again it appears that there is not loose skin on top of lump. But if i try to pinch on either side of the lump it appears to move with my skin, does this confirm again that its indeed fixed or not?
Thank yo


u
doctor
Answered by Dr. Rahul Kumar 21 minutes later
Hello.
By neurological deficit I mean weakness in legs. Incontinence of urine or feces.
Just pain can be due to cyst also.
Ya non pinchability of skin means that it is from the skin and not a tumor.
Sebaceous cyst is just a collection of skin debris.
Breast lump is called is fibroadenoma. There two are not related. However this sebaceous cyst need to be removed by a small surgery hence I want you to get an ultra sound done. This can help in confirming diagnosis. Feel free to ask any other doubt. Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rahul Kumar 8 minutes later
As youve mentioned that its a part of the skin could it be skin cancer or soft tissue sarcoma? It does feel like its more part of the skin but it really doesnt feel like a cyst. Im concerned that it could be skin cancer or soft tissue sarcoma? Can you please provide informarion on why it can or cant be skin cancer or soft tissue sarcoma (would that be a part of the skin as its soft tissue)? Thank you
doctor
Answered by Dr. Rahul Kumar 13 minutes later
Hello,
I can understand your concern.
Carcinoma or sarcoma cannot present just as a lump. There is always an associated ulcer and even involvement of surrounding skin. Cyst it always doesnt mean something filled with fluid. Sebaceous cyst is hard and firmly attached to skin. Please dont worry its not a cancer. Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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