Soft Swelling on Left Side in Neck Pit between Collarbone

[mulkins2008]

I am 31 years old, diagnosed with Ankylosing Spondylitis (Arthritis Disease) and Osteoporosis. I have been on Remicade for one year, then Humira for 6 Months, then switched to Enbrel and I am currently taking 50Mg Weekly. About 6 months ago, I found that I had some swelling on my left shoulder. My Rhuematolgist says it was muslce related or could be some fluid built up. A few months later, I go to Rhuematologist again for regular appointment and show him that I still have soft swelling at times on my left shoulder/neck. He suggest an MRI to be safe. They diagnosed me with a Benign Tumor of the Fatty Tissue and said this requires no treatment and it is not a big issue. I have done some research on the net and found out that there is no way they can tell if it benign or Malignant unless they do a biopsy of the soft tissue. Is this true? Also, since I have a swelling there, I have recenlty (in the past two years) gained 40 pounds. This weight gain has been mostly in my belly area. I have had a good appetite since I have been on the biologic medicine, but what if I have growth there and didn't know it? I am scheduled to go to an oncologist (my choice) for a second opinion. I am concered of the medicines I am using. They are known to cause certain cancers. Can this benign tumor lead into malignant? What is the survival rate of having a benign tumor?

Your answers would be appreciated very much.

Thanks,
Phil

[Dr. Safaa Mahmoud]

Hello,

It is very difficult to tell what a swelling could be without direct clinical examination. Associated symptoms and signs are very helpful to characterize the swelling and guide in defining the possible causes.

MRI can give a good idea about the anatomic characters as well as the possible nature of a swelling like being a cyst, or solid and its fat content.
On the MRI scan, the lipoma is seen as a bright, well defined mass and although MRI can make a benign tumor more likely to be the cause exclusion of malignant nature is not possible. However, the results of the MRI in the context of the clinical information can be strong enough to exclude malignancy.

Based on clinical results, the physician may consider a follow up examination of the swelling if the swelling is thought to be of benign nature.
Swellings that continue to grow are alarming and should be investigated properly.

It is true however; you can never know the nature of a swelling unless tissue diagnosis is done (biopsy and histopathology studying).

Taking a second opinion is always a valid option and hope you will be reassured by the results.

Please keep us updated.
Best regards.