Ultrasound for Soft Tissue Mass

[Katherine364]

Dr. Pho,

I am a 24 year old woman.  Last week my husband discovered a large, irregular, fleshy lump about 4 inches above my knee on my outer thigh.  It is not painful, and I have no idea how long it has been there.  I saw a PA for examination this morning, and she sent me directly to have an ultrasound done.  She also suggested that I have a needle aspiration done at the same time, but I declined.  I wanted to know the ultrasound results before deciding on any kind of biopsy, etc.  

The person who did my ultrasound (I'm not sure if she was a radiologist or a sonographer or what) said that although she felt the lump and could see it on my leg, the ultrasound found nothing at all there.  She said that it was probably just some kind of fatty deposit or lipoma-like thing, and that a needle aspiration would make no sense, because you can't biopsy what you can't see.  She suggested an MRI (although she seemed unconcerned), but I am not convinced that this mass needs further evaluation.  

Here are my questions:

1. Does a negative ultrasound rule out most malignant soft tissue tumors and other dangerous masses?  

2. Do you think further testing would be a good idea?

3. If this is a lipoma or just an area of fatty deposit, is it going to get bigger?

Thanks.

[Agate500]

Is it possible to have an ultrasound done on your neck then?  I have two small (maybe the size of a pea) lumps right next to each other on the right side of my neck.  The doctor said he believed they were lymph nodes and said that I should come back in three weeks to see if they are gone.  They are not red, nor are they tender.  He said if they didn't go away I would have them biopsied with a General.  I am very concerned as I do not like general anesthetics...I would rather have a local.  But even before all of this is it possible to have an ultrasound there?

[Kevin Pho, MD]

To answer your questions:
1) The ultrasound would rule out cysts or more superficial masses.  Lipoma would be the most common cause of these symptoms.  

2) I cannot make this recommendation without seeing the lump.  If the diagnosis is indeed a lipoma, normally no further testing is necessary.  

3) Lipomas may get bigger.  A surgical referral can be considered to evaluate the lesion.  

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[cirella]

Hi there,
I had a lipoma in my arm around the inner elbow area.  I noticed it about 10 years ago and had it xrayed which showed that it was just that, a lipoma.  In 2005 I was noticiing that my arm would be achy and sometimes tingly.  I had the lipoma looked at again and it had grown some.  I decided to have it removed b/c if it continued to grow it would cause more problems like pressing on nerves and such.  If nerves are compromised for too long there can be permanent damage to them.  When the Dr. got in there he found it to be stringy and couldn't remove all of it for fear damaging the nerves around it.  So far, I haven't noticed any more symptoms.  I'm not sure, but lipomas are not fast growing, at least mine wasn't.

Good luck!