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Small hard lump at the back of head, pains on pressing. What could it be?

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My son is 19 years old and has a small hard lump on the back of his head. We have seen two drs one said swollen lymph nodes then another said it was a lipoma and sent us to plastic surgeon the plastic surgeon says he doesn't
Know what it is . Only painful if you press on it my son believe it has gotten smaller from onset well. Over a year ago. he has no symptoms although he has bad allergies and is always congested we are currently doing allergy shots I'm scared
Posted Sun, 9 Jun 2013 in General Health
Answered by Dr. Grzegorz Stanko 32 minutes later

Thank you for the query.

In such situation the best way to get a diagnose is soft tissues ultrasound. The doctor who performs such test is able to tell if this lump is filled with fatty tissue (lipoma) or it has lymph node structure.

Lipoma is usually a soft lump with rounded shape, never causes pain, can slowly get bigger.

Lymph node should be hard, movable, with smooth surface. Can be painful if inflamed.

Such lump can be also a sebaceus cyst. Its a benign skin lesion, filled with whitish masses. It is usually soft, not movable and can be painful when pus accumulates in it.

I suggest you to have an ultrasound of this lump done. If it is a lymph node which bothers you, biopsy (simple needle puncture) can be done. It will allow to take a look at this lump structure under the microscope and tell if it is XXXXXXX or not.
If it is lipoma or sebaceus cyst, can be removed through small incision.

Hope this will help. Feel free to ask further questions.
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Follow-up: Small hard lump at the back of head, pains on pressing. What could it be? 13 hours later
What are the odds that this is something XXXXXXX
It has been there awhile Do lymph nodes stay enlarged for that long can you have something cancerous and have be a systematic
And it appears to be on connective tissue Could allergies or tick bite cause any of this
Answered by Dr. Grzegorz Stanko 5 hours later

Thanks for writing back.

Being honest with you, such lump can be everything. I have mentioned most probable and most common reasons, but not being able to examine it, its really hard to tell exactly what it can be.

Lymph nodes can stay enlarged for a long time. Its because due to inflammation amount of the white blood cells in such lymph node increases. This cells stay there waiting for another infection. Allergy or tick bite causes immune system response and can cause lymph node enlargement.

Cancer usually does not give any symptoms in its early stages. Cancerous lymph node should be hard, not movable, with rough surface and usually painless.

But all of this is just a theory. I understand that you are worried. That is why the best solution for you will be biopsy of this lump (and ultrasound before the biopsy) which will give final answer.

Hope this will help.
Above answer was peer-reviewed by
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