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Subcutaneous swelling in the buttock region.

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Hi, I am a healthy 60 year old male. I have a very hard subcutaneous lump in my buttock near the mid line.It feels calcified and is approx. 2.5 cm long and less than a cm wide oval shaped and smooth and slightly mobile. Have had it for at least a year with no apparent growth. no real pain only after prolonged sitting it gets a little sore from the pressure. No history of trauma. How concerned should I be. Thx for any insight.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 26 Doctors Online


Hello, and thankyou for approaching DoctorSpring with your query.
I have gone through you case and understand your concern.
Please can you answer a few questions so that I can give you an informed opinion.

1) Can you tell me the exact location of the lump, is it along or just above the anal cleft in the midline?
2) Has there been any discharge coming out from the lump?
3) Is it red and does it pain on touching?
4) Does the pain worsen while stretching like bending forward?
5) Are there any pits on the lump or hair protruding from it?
6) Are you overweight an have to sit for long periods of time?

Please reply as a follow up and I shall guide you accordingly.
Thankyou



Patient replied :

Thank you for your reply, it does feel bony I.e. Very hard but you still feel most likely benign. Always had the impression a cyst or lipoma had some give to them?

It parallel along with the midline, no discharge or pus, no abscess. I do sit for most of the day and not overweight, no hairs or pits which I would assumes rules out a cyst,it does hurt a very little when bending over or pressure is applied. Normal skin color. Thx for your prompt reply


Hello,

Yes lipomas are more or less mobile and firm rather than hard. Cysts can get calcified and present hard. There are few reason I would still suspect benign non bony lesion. First of all the pelvic - sacral bone is superficial and flat and there by bony swelling are felt 'very bony'. Not mobile, bone hard.

Second this is the site of repeated impact (by sitting and lying down) so even a lipoma can appear hard. And finally from experience in most cases biopsies of similar lesions reveal soft tissue , not bone. Being said that a physical examination + Xray will be required to be sure. (it could be bit challenging to visualise the swelling in the x ray because of the bony overlap, still).

Hope this helps
Feel free to ask followups/clarifications
Thank you


Patient replied :

Thank you again for your response. One last question and I will close the case. About 2 months after I noticed the lump it got somewhat shorter and flatter or perhaps just shifted position. Is this very typical? Thank you for your time.


Well, it is not typical. But this change in position and size says it is more likely to be a non osseous swelling. (non bony)
Hope this helps. Feel free to ask followups.Thank you


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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