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Avatar universal

Is it all related?

Hello,
I had a Melanoma removed 4 years ago on my right leg and for the last 5 months, I have a lump on the right side of my coccyx.  Since I had a pylonidal cyst removed as a teen-ager, I know this is not the same thing because it is not directly over the coccyx.  It is getting bigger and is now bothering me as I can feel it when I sit.  I lost 30 pounds without an explanation since last August and had since an MRI and a CT-Scan.  They both revealed that I have several abnormal lymph nodes in the neck and supra-clavicle but that the nodes although abnormal because they are a little bigger (.5 of an inch) and the amount of them, they suggested to continue to monitor the situation.  I am feeling a little silly to go back about the lump on my sacrum since they were not too concern about the MRI and CT-Scan but nevertheless it is still bothering be.  Does anyone have any suggestions? Thank you all for your help!

10 Responses
Avatar universal
Hi.
After you were diagnosed to have melanoma, did you undergo further treatment/s?  When did you notice the appearance of the lump on the right side of your coccyx and the lymph nodes in your neck and supraclavicular area?  What is the result of your CT scan and MRI?
Melanoma can recur and can involve the lymph nodes.  Usually, the lymph nodes near the area of the primary lesion are involved.  
I suggest that you have the lump on the right side of the coccyx and one of the lymph nodes in the neck or supraclavicular area biopsied.  That will give you a more definite diagnosis whether you have a recurrence or not.  
Avatar universal
Hello,
Thank you so much for your reply! When I was diagnosed with melanoma on my right leg, I had a second surgery with clear margin that time and no further treatment was required but I have also a diagnosis of Dysplastic Nevus Syndrome and therefore have a high risk of having more melanoma in the future.  I am followed every 6 months for that. I noticed the appearance of the lump on teh right side of my coccyx in December 07 but have had the lump on my neck and supraclavicular area for 2 years.  The CT Scan and MRI both says that I have "Stage 2 Level 2 lumph nodes varing in size between .5 centimeters to 1 centimeters" (if this makes any sense) I think that the supraclavicular one is .8 centimeters.  I was ready to have the supraclavicular node biopsied at the hospital but the Doctor realized after using the ultrasound machine to guide him that it was too close to my lung and was afraid to puncture the lung so I got send home instead.  

I am not sure if I should push to have a biopsy or if I am worrying too much? Thank you for your help!
Avatar universal
Hi.
I would suggest pushing for a biopsy of the lymph nodes.  If the supraclavicular area is inaccessible because of the possibility of puncturing the lung, you can have the lymph node in your neck biopsied instead.  You can also have the lump on the right side of the coccyx biopsied.
Please do post your updates.
Good luck.
Avatar universal
Hello,
Thank you for your comments and guidance, I will push for a biopsy of the lymph nodes and definetely post my updates.

Regards,
Avatar universal
Hi.
Are you experiencing any symptoms now?
Other considerations for the appearance of the lymph nodes in your neck and supraclavicular area would be a chronic infection, lymphoma, or metastatic carcinoma.  I agree with your decision to have a biopsy.  That will give you a more definite diagnosis and rule out possible recurrence of melanoma or the other diseases mentioned.  
Stay positive.
Avatar universal
Hello,
I am not sure what you mean by "symptoms" but I am still loosing weight (30 pounds so far) without trying to loose any.  I am very tired and I come down often with viruses  which indicate to me that my immune system is low.  Having said that I had the enlarged lymph nodes on my neck and supraclavicular for about 1 year before I started to experience the weight loss, tiredness and coming down with viruses which only started 7 months ago.

Further, 2 weeks ago I had pneumonia and a sinus infection and the fever caused cold sore in my nose but with the antibiotic, I now feel better.  I am more bothered by the lump on the right side of my coccyx.  I noticed today that I have to sit very straight on hard surface otherwise I can feel it and it really bothers me.  My doctor had mentioned Lymphomas but ruled it out since I did not have the night sweat and itchiness that usually comes with it.

I also have the ongoing Dysplastic Nevus Syndrome and since I already had a Melanoma, I am told that my chances of having another one are very high.  I have a family history of Melanoma and I am blond, fair skin and blue eyes.  Although it is not genetic as far as I know, my sister (only sibling) died of cervical cancer 2 years ago.  

Thank you so much for your help and feedback!!!
Avatar universal
Hi.
Thanks for the clarification.
The symptoms I was asking could be anything that you are experiencing now.  Right now, you are experiencing weight loss and fatigue.  The symptoms can aid any physician in arriving at a diagnosis.  Though what you are experiencing now are non specific symptoms and can be brought about by many disease conditions.  Further tests can be done to arrive at a more definite diagnosis.
Patients with lymphoma may or may not experience night sweats and itchiness.  Biopsy of a suspicious lump or lymph node is needed to rule out the possibility of lymphoma.
The lump on the right side of the coccyx, if superficial and soft, could be a lipoma.  This is a benign condition and treatment involves excision.  The specimen can then be sent to the laboratory for examination by a pathologist.
Patients with dysplastic nevus syndrome are at risk to develop melanoma.  You have to be extra vigilant in observing any changes in the body or any symptoms experienced.
Avatar universal
Hello,
Thank you once again for the information.  I thought I would give an update on what is going on with me.  The lump on the right side of the coccyx is hard and fixed and feels as if it is part of the bone.  I finally decided to have it looked at and I have an appointment to have an ultrasound done on June 9th.  That was the fasted they could see me.  I am seeing my specialist for the melanoma that same day for my 6 months check up so I will mention it to him as well.  At my last appointment he had suggested that I have dome of my enlarged lymph nodes  biopsided especially the supraclavicular and the one at the back of my neck.  Perhaps I should follow his advice.  
Thank you,
Avatar universal
Hi.
How are you doing?
I think you should push for a biopsy of the supraclavicular lymph node and the lymph node at the back of your neck.  That will give you a more definite diagnosis.
Good luck.  
Avatar universal
Hello,
Thank you for the reply.  I am doing fairly well.  I still have the fatigue, weight loss but it is the lump on the side of my coccyx that is starting to bother me the most.  It is not hurting but I have to sit really straight now otherwise I feel it as I sit on it and it is very bothersome.  I have a few questions; I have started to experience itchiness but I am not sure if it worth to worry about.  When people with lymphomas experience itchiness, where does it usually itch, how often (is it constant)?  Also I am not sure who I should consult for a biopsy of the supraclavicular nodes and the back of my neck, a general surgeon? Finally, does the size matter in determining whether I should have them biopsies?  As I mentioned earlier, the doctor did not want to do anything because after looking at the result of the CT scan and MRI,  he thought they were not big enough.  

Thank you so much for help!!
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