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- Thu Sep 18, 2008 8:42 pm
In April 2008 I found a lump in my breast. I had just finished nursing my second child and wasn't overly concerned, but given my history in 1995 with a breast lump and breast biopsy, I wanted to see my doctor. My doctor advised a mammogram and ultrasound, which I had. They saw the lump and believed it to be "fatty tissue" and said that it should go away with my next couple menstral cycles. The lump remains present and unchanged. In January 2007, I began getting similar, but smaller "cysts" on my labia. My doctor tested me twice for HSV and determined that the test was negative. Now that I have sporadically had those lumps on my labia, the doctor believes that various glands are becomming blocked. He said the only way to manage this would be to excise the gland.
This week, I have had numerous lumps to pop up. One is in the tip of my tounge, one is under my tounge on the roof of my mouth, one on the back of my ear lobe and one on my labia. They are all a little painful, especially the tounge! I feel like my doctor thinks I'm being dramatic about the discomfort and I don't want to appear to be a complainer, but I think that 4 "cycsts" in one week is a little extreme. Are these related to my immune system? Could this be due to stress? I do have some work related stress and two small children, but these health issues are sending me further into worry. Thanks for your feedback!
| Dr. Safaa Mahmoud
- Thu Oct 09, 2008 9:40 am
Breast lump appears to be unrelated to other lumps in your body, so we are going to discuss each separately.
Regarding the recently developed breast lump that was confirmed by mammography and US, close follow up and serial radiological examination is essential considering your past history of breast lump and biopsy. So, I advise you to follow up with your doctor for proper clinical examination, evaluating the need of pathological examination of this lump.
Regarding lumps developed on the external genitalia, it sounds to be Bartholin's abscess or cyst. Bartholin's glands are glands in the vaginal lips that once infected become swollen and painful. In some occasions following infection blockage in their main duct occurs, and a cyst develops. Cysts are felt as a painless swelling. Bacterial infection is the common cause and is treated with antibiotics.
Herpes virus infection exclusion is essential and since you have been tested negative twice its possibility became remote. Tests for herepes infection include viral culture (still the diagnostic test of choice for HSV skin infections) and blood tests (serological testing for AB is commonly used). PCR analysis is not routinely done and is used for more serious types of infections (e.g. suspected CNS infection). Tumors in this part of the body (benign or cancerous) are extremely rare.
Regarding lesions developed in oral cavity and ears, infectious causes should be first excluded including viral, bacterial and fungal (remote) causes.
Herpes simplex is more likely to give symptoms similar to yours and it is true they develop following periods of stress.
Genital herpes is caused by a different type of the same virus that causes gingivostomatitis, recurrent herpes simplex virus infection can occur on the tongue. HPV should be in mind although your presentation is not typically for HPV infection and its sequels but being positive for HPV, it is of consideration. Cancer in the tongue usually develops as a painless bump on one side of the tongue.
Other possible causes include bacterial infections, immune system problem or an allergy.
Possible causes can be determined after careful history taking and examination. Please follow up with your doctor and discuss with him these causes in your next visit.
Please keep us updated.