Many people who feel a lump under their skin think of cancer. Fortunately, most “lumps and bumps” are harmless, said Thomas Donkar, DO, of St. Luke’s General Surgery. Sometimes they become infected or may cause pain, discomfort or embarrassment, all excellent reasons to surgically remove them.

Schuylkill and Carbon residents need to go no further than their closest St. Luke’s Campus for the removal of a bothersome lump or, for that matter, most other types of general surgery. Dr. Donkar performs surgery at St. Luke’s Miners Campus and sees patients at the Campus Medical Office Building. Likewise, St. Luke’s surgeons in Carbon County treat lumps and bumps at St. Luke’s Carbon Campus.

“It’s important to know that a general surgeon, such as myself, is always available,” said Dr. Donkar, who also completed a year of colorectal surgery training. “We do all we can to keep patients close to home.”

Among the surgeries Dr. Donkar performs is removing “lumps and bumps,” which he defines as something you feel under your skin that doesn’t go away or get smaller. Unless infected, they do not change the appearance of the skin’s surface or have a head. The two most prominent “lumps and bumps” types are epidermal cysts and lipomas. About 1-2% of the population have lipomas. Even more common are epidermoid cysts, which are enclosed sacs filled with fluid, pus, air and an oily or cheese-like substance.

“These cysts generally do not go away,” he said. “They can remain for years. I treated one gentleman who had a cyst the size of a pea for over 40 years and never had any problems. He saw me because it grew to the size of a golf ball because it became infected.”

Lipomas form between the muscle and skin. Like cysts, they can appear anywhere on the body but commonly on the back, trunk (torso), arms, shoulders and neck. They may be hereditary. “If your father or mother had them, you may have a slight risk of developing them as well.”

Lipomas can develop into a liposarcoma, a rare type of cancer occurring in four out of 100,000 cases. Additionally, soft-tissue sarcoma, another rare cancer, can look like a cyst or lipoma and appear in similar places. Distinguishing between a sarcoma and a growing cyst or lipoma can be difficult and should be thoroughly evaluated by a professional.

Fortunately, most cysts and lipomas are harmless, but can become infected, causing inflammation, swelling and pain. The skin may become red, and the cyst or lipoma may develop a head and drain fluid.

Anyone suspecting they have an infected cyst or lipoma should see their primary care doctor (PCP). If caught early enough, the doctor may prescribe an antibiotic to clear the infection. However, if it is badly infected, the PCP may treat it or refer the patient to a general surgeon.

Both cysts and lipomas are treated with clinical lancing, a minor surgical procedure performed by treating the area with an antiseptic and then making a slight prick or incision to puncture it. Sometimes, the physician will lance the cyst or lipoma in the office, but depending on its size, location and degree of infection, might do so in the operating room.

Dr. Donkar has evaluated and treated patients with lumps as large as a melon. Factors determining removal include whether the lump is growing or if it causes the patient pain, discomfort or embarrassment. Women are more likely to remove lipomas, particularly those on the neck, back, upper arms and shoulders, for cosmetic reasons. He recalled two female patients with lipomas on their sides that were as large as grapefruits. They both wanted them removed so they could feel comfortable wearing sleeveless, strappy and off-the-shoulder or tightfitting tops.

While “lumps and bumps” are not necessarily harmful, Dr. Donkar said it’s essential for people to be aware of lumps or bumps. “They should monitor them, and if they notice any changes, they should seek medical care,” he said.