Lump under scalp

[marmorgan]

I'm a 34 year old female. About 8-10 months ago I noticed a small lump about 1 inch above my hairline on the right side of the front of my head. No noticable marks on skin or near hair folicle.It feels firm and seems to either slide around a little bit or the skin slides around it, I really can't tell. An X-ray showed decreased density and follow up CT scan (with and w/out contrast)came out negative for pathology (I can't remember the exact wording). After pressing my General Practitioner as I felt it was getting bigger, he said I could see a surgeon if I wanted it out but didn't appear to be very concerned. After after going from a surgeon to a dermatologist and now to a plastic surgeon who is removing it in a couple of weeks, I am really getting concerned about the growth and the implications of that. Six months ago it was roughly the size of a pea, it is now about the size of a lima bean. Not a huge growth, but noticable. I'm really worried and would love to hear something to alleve my fears of cancer.

[Kevin Pho, MD]

A cyst would be the most common cause of a soft tissue lump that you described.  With a negative CT scan, it would be less likely that this is cancer.  If the plastic surgeon suspects something suspicious when it is removed, then it will be sent for further analysis to rule out the possibility of cancer.  

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.

Thanks,
Kevin, M.D.

[surgeon]

By far the most common thing is a sebaceous cyst, which is a plugged oil gland. They can happen nearly anywhere you have skin, and are particularly common on the scalp. I'm amazed your doctor would have ordered an xray and CT scan for such a thing. In nearly all cases they can be diagnosed by exam only; it's usually a simple office procedure to remove them. It's also safe to leave them alone if they don't bother enough to want removal. They may continue to grow, and they can become infected, which is unpleasant, but they're not otherwise dangerous. What you describe is almost certainly a sebaceous cyst.  Cancer in that location with the characteristics you describe is nearly unheard of.

[ontherecord]

I have a question for you, unrelated to this thread but nevertheless I could use an educated opinion on this matter.

When someone sustains a head injury, doctors have to determine the severity of the injury from my understanding.  Based on how the patient presents, they determine whether it's physiologic or structural.  

If it's not a structural injury, is *Actual* brain damage still possible? Just because injury doesn't show up on the CT, does that mean it didn't happen?

Second question: lets say the patient didn't lose consciousness, didn't have post-traumatic amnesia, didn't have dizziness, headache, or nausea, but complained of continuing cognitive slowing....is it possible that brain injury could have occured from a hart hit in the head which didn't produce the classic symptoms?

what are your thoughts? (lets say this patient is an otherwise healthy mid-twenties male who sustained this head injury in a recreational activity).

Thanks in advance.

[Cindylou]

I have a lump also on the right side by my hairline also.  It has been there for about 5 years.  When I had very dry skin it,shrunk up.  Now that there is more oil on my skin, it has come back.   I actually get them all over the place, some hurt, some don't. They are just annoying.  I tend to get them when I am under alot of stress. My doctor said the same thing as this Med Doc. has said.

[marmorgan]

Thank you for the comment. I was looking for feedback to made me worry less and I feel better about it.

[mfm]

A related discussion, sebaceous cysts under scalp was started.