What is my lump

[roorooep]

Hi. I am a 49 y/o female.  Several weeks ago I noticed a soft movable lump in my right groin area.  I have a history of a right inguinal hernia which was repaired appx. 27 years ago.  My physician thought it not to be a recurring hernia but rather a enlarged lymph node and placed me on antibiotics and ordered a Ultrasound of the right groin.   The ultrasound suggested it to be a complex cyst.  I was  then referred to a surgeon  who  also thought it to be a  enlarged lymph node and ordered a CT of the abdomen and Pelvis w and w/o contrast.  The CT describes the area as a ovoid fluid collection and fatty density w/o significant enhancement which may represent a right inguinal hernia with free fluid.  It further states the fatty density is of unknown etiology but may represent minimal herniated fat or less likely a lymph node.  It continues to note that there is no evidence for significant lymphadenapathy within the pelvis or abdomen.  The surgeon did  his own in office F/U ultrasound and he states it is a "lipoma of the cord, therefore represents a recurring cyst" and is recommending surgery.  Can you tell me what test is more accurate and what you think this lump might be.

[Garry Choy, MD, MS]

That is reassuring that the CT scan does not show a hernia containing bowel loops.  It is not uncommon to have fat containing inguinal hernia which is benign.  Also lipomas can also occur in that area that is also a benign finding.  Lymphadenopathy would certainly need to be ruled out in the case of a lump that you feel but it seems that CT did not detect any enlarged lymph nodes.  CT is probably the most accurate in this case.  Before you have surgery, I suggest you go over the images with another surgeon for a second opinion just so that they took a look at the actual images.  

Best regards and please keep me updated!

[roorooep]

Thanks for a speedy response.  Yesterday I did consult another surgeon who reviewed the CT images with me.  She also preformed a physical exam and agrees with the other surgeon that this is a hernia.  I plan on surgery repair with mesh within the next several weeks.  Thank you for advice.