Question: I noticed a small, painless lump (that is about the size of a pea) under the skin of my left calf
At first I thought it was an insect bite, but it's not red and it doesn't itch. The lump is under the skin, and located on the muscle (near the base of the muscle that is defined ) of the left calf. I don't feel any tingling, numbness, or warmth in that spot. When I press on the lump it feels firm but it doesn't hurt. There are no lesions or sores on the surface of the skin in that place; just a bump. In the past I have gotten night cramps in both calves when stretching my legs upon waking or in the middle of the night.

Thank you for getting back to me. Just FYI, the night cramps only happen occasionally (the last one was several weeks ago) if I stretch my legs too rapidly or too suddenly upon awakening. The cramp lasts only momentarily subsides once the muscle relaxes.

Hello Doctor XXXXXXX

Since I last sent you my follow-up comment, I went to see a physician. I forgot to mention before that I have been living and working in South Korea since 2009.

For the past four months I have been receiving treatment at a skin clinic in Seoul. The doctor there is very good and speaks English. I recently had a small abnormality removed from the surface of my left XXXXXXX Apparently it was an old abrasion that had not healed properly. The doctor applied liquid nitrogen to freeze it off and over the past few months the area has healed, leaving just a tiny scar.

I went to see the doctor on 1/14 for follow-up and while I was there I showed him the aforementioned, subcutaneous lump on my left calf. His assessment was that it's not Lipoma because of the degree of firmness. He suggested that I have it removed and a biopsy performed to rule out any malignancy. He added, however, that he felt it is benign. He said that after the excision I might require plastic surgery to reduce the appearance of the resulting scar.

I won't be able to have anything done until late February. He had told me not to worry, but I am worried nonetheless. The area where the lump is located is a bit sore (when I press on it); but I think that's from the doctor pinching the skin there between his fingers in order to feel the lump.

I was examining my right calf this morning and I felt a smaller lump (about maybe 1/3 the size of the other one) Near that area I noticed a small, protruding vein near the surface of the skin. It does not appear to be of an abnormal color and it is not painful... neither is the lump.

On an unrelated note... on 1/13 I noticed some inflammation on the smaller toes of my right foot. This was accompanied by some slight itching. The next morning while showering I felt some tenderness on the underside of the two last, smallest toes and during the day I experienced discomfort while walking. When I returned home I removed my shoes and socks and discovered a small blister on the underside area between those two toes. The blister had apparently ruptured because there was a small amount of dried blood on the inside toe of the right sock.

I soaked both feet in a tub of warm water and borax soap, then rinsed and dried them. The top part of the foot was itching slightly so I applied both some anti-itch ointment and some antibiotic ointment to the affected areas. Then I put on clean socks and took two Acetominiphen caplets. After soaking my foot, the tenderness was not as noticeable. At this writing it has lessened, although there is still a slight itching on the top part of the foot, near the toes.

Now, this had happened to me before... during the Thanksgiving weekend; only it was the left foot that had been affected. On that foot, however, there had been no blister... just itching and inflammation. Part of the reason for it, I think, was that at that time I was wearing a new pair of athletic hiking shoes. I think the left shoe had been creating undue pressure against the smallest toe; pressing it up against the adjacent toe.

When I press on the top of my right foot, near the toes, there is still some soreness; but, as I said before, it seems lessened from the previous day.

In addition to all of the above; I noticed two days ago that I have some inflammation in my right knee. I remember that, earlier in the week I had bumped my knee on the underside of a desk as I was getting up out of my chair. The area I had bumped is located just above the knee joint where it attaches to the thigh, It's still a little sore if I press on the area and there's a slight bruising. The inflammation I'm also experiencing, however, is off to the side of the kneecap and feels like it's in the muscle or tendon just below the skin. Occasionally when sitting or walking I experience a moderate pinching sensation in that area. I'm not sure what can be the cause. The discomfort is mild, occasional but nevertheless noticeable.

Sorry for the length of this follow up question... but I am concerned. I'm also worried that when I eventually have the lump removed from my left calf that it might be something serious. It does not appear to have changed in size since I first noticed it.

Thank you for getting back to me. I went to see my doctor at the local clinic in my town and I reported to him what both you and the doctor at the skin clinic had told me.

He took a pen and marked the edges of where the lump on the left calf is located and then measured it as being one centimeter in length. He suggests that it could be a lump of fibrous tissue and doesn't recommend having it excised unless it gets bigger. His assessment is that whatever it is it is either slow-growing or may reduce in size.

I wanted to report that the inflammation on top of my right foot, just above the toes, is lessened. I have continued to apply moist heat and Neosporin to the area where the blister occurred. There is a pocket of dead skin on that area, but I think eventually it will peel off on it's own.

I was out walking yesterday and I may have irritated my right knee a bit. In the evening I noticed it was a bit sore, so I applied moist heat to it and then slept with a heating pad overnight. The inflammation is less noticeable today.

I do notice, however, that I have a slight tingling sensation in my calves, ankles, and feet. I am NOT experiencing any numbness where I can't feel sensations like touch (lightly pricking with a closed ball-point pen, pinching the skin) or hot/cold.

I have had lower back problems in the past and it was suggested that I may have Sciatica. I have experienced similar tingling in the past and I think it may have had to do with a pinched nerve.

However, because I now have the small lump in my left calf... I'm concerned that maybe the two might be connected, somehow. I can feel the lump press into the calf muscle if I press on it with my finger. There is a slight discoloration (redness) on the surface of skin in that spot. It appears to be a bruise from having been pinched so much between Saturday and today.

Hello Dr. XXXXXXX

I should clarify my earlier follow-up statement:

When I went to see my local doctor on Monday, I showed him the FIRST lump; the one I had noticed in my left calf on January 2 and that I had written to you about. It was this same lump that I had subsequently shown to the doctor at the skin clinic this past Saturday. The doctor at the skin clinic had examined that lump and his assessment was that it is benign and that I shouldn't worry too much about it. He had recommended, though, that I get it removed and examined. At that time I had not discovered the smaller, softer lump in my right calf.

On Monday I went to see my local doctor and it was the lump on my left calf that he had marked with a pen and measured as being one centimeter in length. Again, he had recommended that I not get it removed unless it started increasing in size. He also examined my right calf. On the right calf is a slightly-protruding blood vessel and just maybe a fraction of a centimeter above that, I can feel with the tip of my finger a smaller (less than 1/4 centimeter), softer subcutaneous lump.

So I'm a bit confused... one doctor suggests having the first lump excised and another doctor says wait and see. If I were to wait until it got bigger, wouldn't it be too late by then to do anything about it? If it were something malignant, just how fast would it grow? Are we talking about a period of days, weeks, or months?
Attached are two photos I took of my left and right calves, just a few minutes ago. I am pinching the lump in the left calf by the edges. I measured it myself and it is actually just under one centimeter in length.

In the first photo you can see that there is a slight bruise on the surface of the skin and it is slightly sore from being pinched. It's only sore to the touch, otherwise it's not noticeable. You can also see that there is also a small mole on the calf just below where the lump is located.

In the second photo, the lump in my right calf is difficult to find and cannot be grasped between the fingers. If I run the tip of my finger over the area that is marked in pen I can feel it. Be advised, though, that the circle (which itself measures less than half a centimeter) does not represent the actual size of the lump, which is much smaller. Any protrusion you see on the right calf is actually that of a bulging vein.

It was difficult taking photos that are any clearer than this, sorry!