Lump On Abdomen Must Be Examined

Dear Dr. Dave and Dr. Dee,

Hi, I am an overweight female of 40 yrs and have a hard defined lump where my stomach is, i.e. in between my rib cages between my breastplate and my navel. My doctor says this is just an abnormal fat distribution but he has not actually felt it. Is it worth worrying about?

Signed,

Stomach tumor

Dear Stomach tumor,

Most doctors would be hard-pressed to diagnose a lump without having felt it. The first and most important step is to make sure and have a hands on exam by your physician. Suspicious lumps may require further tests and/or biopsy to determine the diagnosis or rule out malignancy.

The most commonly seen lumps are benign fatty growths (lipomas), and benign skin lumps (sebaceous cysts). A physician can diagnose these easily on physical examination. Lipomas and sebaceous cysts generally require no specific treatment unless they become troublesome because of their size or location. Sebaceous cysts sometimes become infected, and need to be drained, and subsequently removed. Generally speaking lipomas are soft, not hard and defined.

In the midline an abdominal wall hernia or diastasis is always a possibility. Occasionally a patient discovers a "lump" in the midline below the breast bone, which is a normal anatomic structure called the xiphoid process.