A subcutaneous mass is a lump or growth that forms just beneath the skin’s surface. The term “subcutaneous” refers to its location within the subcutaneous tissue, which is the layer of fat and connective tissue found directly under the skin. While the presence of a lump can sometimes cause concern, many subcutaneous masses are benign.
Understanding Subcutaneous Masses
Subcutaneous masses are located in the layer of tissue situated between the skin and the underlying muscle or bone. This layer, known as the hypodermis, is primarily composed of fat, connective tissue, and blood vessels. They might feel soft, firm, rubbery, or even hard to the touch, depending on their composition.
A subcutaneous mass can be movable, meaning it shifts easily when gently pushed, or it can be fixed and feel attached to deeper structures. Their size also varies, ranging from a few millimeters to several centimeters in diameter. Some masses may be readily visible as a bulge under the skin, while others are only detectable by touch. The appearance and feel of a subcutaneous mass can provide initial clues about its nature, though a medical evaluation is often necessary for a definitive diagnosis.
Common Causes and Types
One of the most common types is a lipoma, which is a soft, fatty lump that develops just under the skin. These growths are movable and often feel doughy or rubbery. Lipomas tend to grow slowly and rarely cause pain unless they press on nerves or grow in an awkward location.
Cysts are another frequent cause of subcutaneous masses, presenting as sacs filled with fluid, pus, or other material. Epidermoid cysts, for instance, are common and arise from trapped skin cells and their secretions beneath the skin. These cysts often feel firm and may have a small dark pore in the center. Another type, sebaceous cysts, forms when a sebaceous gland becomes blocked, leading to a build-up of sebum.
Fibromas, which are growths of fibrous tissue, can also appear as subcutaneous masses. These are generally firm and can sometimes be skin-colored or slightly darker. While most subcutaneous masses are benign, some can be more serious.
When to Seek Medical Advice
Certain signs and symptoms should prompt a visit to a healthcare professional. Rapid growth of a mass is a particular concern, as is any new onset of pain or tenderness. Changes in the skin overlying the mass, such as redness, warmth, or discoloration, warrant medical attention.
A mass that becomes fixed to deeper tissues or feels increasingly hard over time should be evaluated. If a previously removed mass reappears in the same location, this also signals a need for medical assessment. Any of these changes, or if the mass is simply causing discomfort or cosmetic concern, indicates that a medical professional should examine it to determine its nature and appropriate next steps.
Medical Evaluation and Next Steps
When evaluating a subcutaneous mass, a doctor will typically begin with a thorough physical examination. During this examination, the physician will assess the mass’s size, shape, consistency, and whether it is movable or fixed. This initial assessment helps in forming an educated guess about the potential nature of the lump.
To gain more detailed information, imaging studies may be ordered. An ultrasound is often the first choice due to its ability to differentiate between solid and fluid-filled masses. In some cases, a Magnetic Resonance Imaging (MRI) scan might be used to provide a more comprehensive view of the mass and its relationship to surrounding tissues.
If the nature of the mass remains unclear or if there is any suspicion of malignancy, a biopsy may be performed. This involves taking a small tissue sample from the mass for laboratory analysis, which provides a definitive diagnosis.
Based on the evaluation, management approaches can vary. For benign, asymptomatic masses like many lipomas, observation may be recommended. If a mass is symptomatic, growing, or cosmetically undesirable, surgical removal is a common option. The specific course of action depends entirely on the diagnosis and the individual’s circumstances.