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Painful Lump On Right Calf, Numbness In Outer Edge Of Lump. Done Venous Doppler Ultrasound, X-ray. No Relief. Treatment?

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Posted on Sun, 15 Jul 2012
Question: Hello. I have a lump on the left (inner) side of my right calf, about two inches above my ankle. I am a 28 year old female with no past history of any kind of tumors, cysts, etc. I experienced no trauma to my calf. This lump started to become noticeable about four months ago, and it seems to just be getting bigger. I have seen my DVT since I was having a lot of pain. The podiatrist didn't believe it was a DVT- she thought my pain was concentrated around my tibia so she thought it could be fractured. She sent me for a venous doppler ultrasound and an x-ray. No DVT and no fracture. When the lump kept growing and the pain began to get worse, I returned to the podiatrist (I didn't understand why I was sent to her instead of another type of specialist) and she was very dismissive of my concerns, saying any lump was probably scar tissue from an old muscle tear. I have never had any kind of traumatic injury to my right leg at all, so there should be no scar tissue. Also, would scar tissue cause the kind of pain I am having? I am unable to do much walking at all on my right leg because it is too painful. About half an inch (moving towards the front of my leg) from the lump my leg has become completely numb in one area ( the numbness is slowly spreading) and is tingly on the outer edges of the numb spot. I get pain in that area that I can only describe as burning- but a pretty severe, unbearable burning that often feels as though there is a large slice in my leg that someone poured salt into (not to be overly dramatic or anything). I'm not a doctor (obviously), but it seems that this lump, whatever it is, is somehow impinging upon nerves in my leg to cause that kind of pain. In the area of the lump itself there is just soreness and a dull ache. It is extremely tender if I try to press on the lump and the pressure can also trigger the nerve pain. The lump has clearly grown over the past few months since these symptoms began- it is visible to friends and family who are quite concerned. Oh, I don't know if this is relevant, but I should also add that my grandmother had a lump in the exact same area (same leg even) about twenty years ago with the exact same types of symptoms- the burning pain, the numbness, and the tenderness around the mass. The whole mass was removed, but she does not remember ever being told what is was (the surgery permanently damaged her leg so she was focused on that), so I don't have much to go on there. Unfortunately, my doctors are not concerned about my lump. My primary cannot see me for another few months, and I don't feel that I can wait that long to find out what is going on. I know that was a long explanation to get to one question- what type of doctor should I see? Clearly the podiatrist is not helpful and refused to order any imaging studies. I was thinking an orthopedist since it is a limb that has pain, but do they handle these types of things? I don't want to run from specialist to specialist. What could be going on and what type of specialist should I make an appointment with to have the best chance of getting answers? This lump seems to be getting bigger and more painful everyday- I don't want to wait any longer. Thank you so much for taking the time to read all of this and get back to me.
doctor
Answered by Dr. Hema Yadav (2 hours later)
Hello XXXXXXX
Thanks for posting your query.
It's unfortunate that even after consulting two doctors you have not been provided a diagnosis for your lump.
You definitely need to get it investigated by further scanning like CT/ MRI scan to rule out a soft tissue tumour . Since it is causing symptoms as described it is most probably impinging on the nerves too.
If the scan does not provide an exact diagnosis but rules out any blood vessel involvement then the confirmation can be done by a biopsy.
The best specialist for such condition is a surgeon either a general surgeon or an orthopedic surgeon. Since you also have painful limitation of movement ( walking) it's advisable you consult an orthopedic surgeon . Yes they do treat and operate on soft tissue swellings on limbs .
Please do not stress yourself as it will only add to your problems.
Do not jump to any conclusions before getting a confirmed diagnosis . Remember even minor benign soft tissue tumours like lipomas can sometimes cause nerve entrapment and severe pain , such condition is easily treated with surgical removal of the lump .
So be positive and go ahead with your specialist consultation.
Hope I have answered your query.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hema Yadav (3 hours later)
Thank you for your response, Dr. XXXXXXX I really appreciate you taking the time to answer my questions. Tomorrow I am going to make an appointment with an orthopedic surgeon. I wanted to have an MRI, but the podiatrist I saw said she didn't think it was necessary. Hopefully the orthopedic surgeon will feel differently. The podiatrist really made me feel like it was all in my head even though I can see and feel the lump.
Sometimes I do wonder if I'm wrong though because the lump is not always noticeable. At times, you just have to glance at my leg to see that it is swollen and there is a lump, and it feels extremely hard when I touch it. Other times, however, the area feels soft unless I push harder and can then feel the lump below the surface. It's as though it moves. Is that possible? Or is it possible that I'm completely wrong and there's no lump, just a scarred muscle as the other doctor said?
Also, a few friends have said "Oh, don't worry about it, it's probably just a cyst XXXXXXX Is that possible? Could a cyst impinge on the nerves in my leg?
Again, thank you for your time.
doctor
Answered by Dr. Hema Yadav (3 hours later)
Hello,
Thanks for the follow up.
Yes it is possible for a lump to be less visible and reappear especially if it's arising from deeper tissues and has a muscle overlying it . It can be felt as mobile due to stretching and contraction of muscle and it can still cause nerve impingement .
A cyst is usually a soft or firm fluid filled swelling , so doesn't seem much likely but an MRI would be able to detect and confirm the same .
Please don't blame yourself. You have every right to get a confirmed diagnosis as a vigilant health conscious individual even if it turns out to be a benign lipoma or cyst.
Hope that answers your query.
Kindly accept my answer if you have no further queries.
Wishing you good health .
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Hema Yadav

Pediatrician, Infectious Diseases

Practicing since :2005

Answered : 1528 Questions

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Painful Lump On Right Calf, Numbness In Outer Edge Of Lump. Done Venous Doppler Ultrasound, X-ray. No Relief. Treatment?

Hello XXXXXXX
Thanks for posting your query.
It's unfortunate that even after consulting two doctors you have not been provided a diagnosis for your lump.
You definitely need to get it investigated by further scanning like CT/ MRI scan to rule out a soft tissue tumour . Since it is causing symptoms as described it is most probably impinging on the nerves too.
If the scan does not provide an exact diagnosis but rules out any blood vessel involvement then the confirmation can be done by a biopsy.
The best specialist for such condition is a surgeon either a general surgeon or an orthopedic surgeon. Since you also have painful limitation of movement ( walking) it's advisable you consult an orthopedic surgeon . Yes they do treat and operate on soft tissue swellings on limbs .
Please do not stress yourself as it will only add to your problems.
Do not jump to any conclusions before getting a confirmed diagnosis . Remember even minor benign soft tissue tumours like lipomas can sometimes cause nerve entrapment and severe pain , such condition is easily treated with surgical removal of the lump .
So be positive and go ahead with your specialist consultation.
Hope I have answered your query.
Regards