Properly identifying lumps and lumps can be decisive for patient treatment and health; medical evaluation is critical to avoid risks and ensure the best result
Lumps on the skin or just below it are very common in the daily office of the office. Most of the time, they are simple situations, such as lipomas or epidermoid cysts, which do not bring greater problems. However, in some cases, they can hide more serious diagnoses, such as soft parts or increased lymph nodes by. The secret is knowing how to differentiate what can wait from situations that require immediate attention.
Common injuries… And when it comes to light the alert
- Lipomas – They are usually soft, mobile, grow slowly and do not hurt. When they are just below the skin, ultrasound usually resolves the diagnosis without mystery.
- Epidermoid cysts – usually firm or elastic, almost always with a central point (the famous poro). They can ignite, infect and even drain. The ideal treatment is to remove the entire cyst, including the capsule, preferably when it is not inflamed.
Red flags
- Nodule larger than 5 cm, which is growing, deep or attached to internal tissues, very hard or reappearing after withdrawal.
- Mass that, in resonance, has worrying signs such as necrosis or fascia invasion.
- Supraclavicular lymph nodes or any ganglion increased for more than two weeks, no clear, hardened, and greater than 2–3 cm.
- Sebaceous Carcinoma – Malignant tumor of the sebaceous glands, common in the eyelid, but that may appear in other areas of the skin. Often, disguises a cyst or chronic inflammation, delaying the diagnosis.
Why not wait
Withdrawing a sarcoma without planning (“displeasured exile”) is a serious problem: increases the risk of recurrence, may require more extensive reoperations and impairs the prognosis. Follow the right path – expert evaluation, exams such as ultrasound (initially), resonance (when necessary) and then biopsy, if indicated – accelerates the diagnosis and reduces errors.
How to investigate
Clinical evaluation and initial exams
- Conversation and Physical Examination: Ask about evolution time, growth, pain, previous infections, cancer history. Evaluate size, mobility, depth, signs of inflammation and, in the case of cyst, the presence of the pore.
- Image exams: Ultrasound is the first choice for superficial pasta, as it locates, evaluates vascularization and can guide biopsies.
- Resonance: indicated when there are signs of alert, doubts in ultrasound or forecast of more complex surgery.
- Biopsy: Avoid thin aspiration puncture in suspicious pasta. Prefer guided biopsy or incisional biopsy. For typical and asymptomatic cysts, withdrawal already serves as a diagnosis and treatment.
When operating at the outpatient clinic
- Epidermoid cysts with recurrent pain, infection, growth or aesthetic discomfort.
- Lipomas that grow, cause pain, compress nerves, generate aesthetic discomfort or are large/atypical (in these cases, image assessment is fundamental).
- Suspected sarcoma lesions should not be operated without planning; should be referred to expert.
Patient guidelines
Surgery is usually performed with local anesthesia, quickly and high on the same day. Postoperative pain is usually light and can be controlled with simple painkillers. The risk of infection is low, and local anesthesia reactions are extremely rare.
SUMMARY AND IMPORTANCE OF CORRECT CONDUCT
Most superficial lumps are benign, but some cases require fast action. Following the conduct “Initial Evaluation, Exams When necessary and proper biopsy” ensures safety and avoids errors that may compromise patient treatment.
Dr. Patrizio Morisson-CRM 52.83566-8 / RJ-RQE 40.203
Digestive Surgeon and Member of Brazil Health
