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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For A Painful Lump On The Head

Hi, I m 21 years old, approximately 5 years ago a lump formed near the center of the crown of my head. I can see hair ceasing to grow there now. The lump is relatively painless just a slight discomfort when I put pressure on it, but is nearly as hard as bone. It s about a quarter size, sticking out no more than 10-15 centimeters. It had previously never caused me any problems so I was not concerned but now I ve been getting mild head aches and I can feel as if blood is rushing to that point sometimes, like a pulsating sensation. Any advice or information is much appreciated.
Thu, 5 Nov 2015
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General Surgeon,  's  Response
Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-Sebaceous Cyst / or it could be Dermatofibrosarcom Protuberance.(DFSP).It could be due to Increased blood gushing in, indicates locally invasive growth in the crown of your head.
CT skull to assess local invasion and metastasis in bones and FNAC biopsy to fix the diagnosis by a Surgeon is needed.

Treatment-
If Sebaceous cyst-it would be treated by Simple Surgical Excision with biopsy.
But for DFSP-which is a locally recurring tumor,Wide Margin Surgical Excision is needed.IF nodes are involved its removal is also needed.
Radiation would be needed for the local recurrence.
MOHS micro-scopic surgery is needed to avoid its recurrence.
Chemo with Imatinib-for locally recurrent and metastatic DFSP-FS(Fibro Sarcoma type) is suggested

Hope this reply would help you to plan further treatment with your doctors.
Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you.
Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS
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Suggest Treatment For A Painful Lump On The Head

Hi,Dear,Welcome to HCM. Based on the facts of your query,You seem to suffer from-Sebaceous Cyst / or it could be Dermatofibrosarcom Protuberance.(DFSP).It could be due to Increased blood gushing in, indicates locally invasive growth in the crown of your head. CT skull to assess local invasion and metastasis in bones and FNAC biopsy to fix the diagnosis by a Surgeon is needed. Treatment- If Sebaceous cyst-it would be treated by Simple Surgical Excision with biopsy. But for DFSP-which is a locally recurring tumor,Wide Margin Surgical Excision is needed.IF nodes are involved its removal is also needed. Radiation would be needed for the local recurrence. MOHS micro-scopic surgery is needed to avoid its recurrence. Chemo with Imatinib-for locally recurrent and metastatic DFSP-FS(Fibro Sarcoma type) is suggested Hope this reply would help you to plan further treatment with your doctors. Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Good Day!! Dr.Savaskar, Senior Surgical Specialist M.S.Genl-CVTS