Medical-Type Question, re: cysts

Factual Questions
1

I guess I’ll add a caveat to this; a doctor’s appointment is made, I’m just kind of curious/concerned about this.

About 6 months ago, I started getting a hardish lump just below the middle of my back, right over the spine. Started off itchy as it grew, but nothing now. I know it’s not attached to the bone 'cause it moves with the skin.

While at the emergency room for another matter, I mentioned it to the doctor who commented that “it was just a cyst, nothing to worry about,” so I didn’t.

However, just this morning, it started to hurt, just a little, but I prefer no pain whatsoever, and I find this a tad worrisome. Anyway, I’m kind of curious, should I show up at the doctor with my will signed and ready to go, my bag packed for a hospital visit or my insurance card for oodles of meds or what?

A Google search on “subcutaneous” or “subdermal” cyst comes up with a hell of a lot of very disturbing pictures of various skin conditions (FWIW, the subdermal cysts are the only non-gross ones), or incredibly detailed medical journal articles of which I can’t make heads or tails. WebMD has only three articles on subcutaneous ones, and they’re all rather vague or uniformative.

Some background: 28 year old smoker, relatively fit (could be better, could be much worse), tattoo over my spine as well, but not in the same area. Apparently, my uncle has had a few as well, but that’s the only detail I’ve got. Medico Dopers? Dopers with interesting hobbies? What the hell causes this and what are the ramifications? Any ideas? Many thanks in advance for whatever info you could give me.

2

Doctors are rarely wrong when they diagnose a cyst by palpation. Back in the (very) old days I gave anesthesia at a major cancer hospital. In those days, a woman with a breast lump would be put to sleep for the excision of the lump and a frozen section would be done. This would be followed by mastectomy if malignant. I would often ask the surgeon if he thought it was malignant before I put the patient to sleep because the technique was different for a long procedure. These guys were never wrong. They would say “Nah, it’s just a cyst.” or “This is cancer.”

That said, if the cyst is in a place that gets irritated a lot (e.g. under a belt or a bra strap) it’s reasonable to have it removed. The new soreness could mean it is getting infected, experiencing a sudden growth spurt, or that you somehow traumatized it.

Most cysts seem to be of the fatty (sebaceous) type and are nothing to worry about unless cosmetically displeasing.

I would not be worried. Get it removed if it bothers you.

3

Short answer: Most cysts under the skin (subdermal, epidermoid, lipoma) are nothing to worry about; non-malignant, not a manifestation of underlying disease, etc. They can be nuisances when they get inflamed or infected, and are usually easily excised. One should consult a doctor if it’s a nuisance, or if one wants to make sure it’s not one of the fewer than 1% of cysts that can be a bigger problem. Since you say you’re already doing that, I’ve nothing else useful to add.

Qadgop, MD

4

ejrn and Qadgop, many thanks to you both. I guess I can let go of the stiff upper-lip, “don’t worry about me, baby,” martyrtom that I’d planned on adopting. Oh well.:wink: