[40F] With growing shin lump and persistent dry cough

Patient Description

A 40-year-old female presents with a lump on her shin that appeared approximately 8 months ago and has since grown around the leg. The lump is occasionally hot to the touch and causes a burning sensation in the limbs, though it does not cause pain or affect mobility. The patient also reports a persistent mild dry cough lasting the same duration. Additional symptoms include occasional hot flashes, swollen lymph nodes in the neck, sore throat, persistent fatigue, and increased appetite. There is a significant family history of cancer on the maternal side, including multiple myeloma. The patient smokes about 5 cigarettes a day and has a history of cholecystectomy and endometriosis. She takes ibuprofen for pain management. No recent infections, unexplained weight loss, or imaging tests have been reported.

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Arora's Assessment

What might be happening

Your symptoms could be related to several conditions:

  1. Bone or Soft Tissue Growth: The lump on your shin that is growing and feels warm could be a benign growth like a lipoma or cyst, but given its size and growth, it’s important to rule out more serious conditions like a bone tumor. A biopsy or imaging tests like an X-ray or MRI might be needed.

  2. Multiple Myeloma: Given your family history and symptoms like bone pain, fatigue, and the lump, multiple myeloma could be a possibility. This is a type of blood cancer that affects the bones and immune system. Blood tests, imaging, and possibly a bone marrow biopsy are typical diagnostic steps.

  3. Chronic Cough: Your persistent dry cough could be related to smoking, but it’s important to rule out other causes like asthma, chronic bronchitis, or even a lung infection. A chest X-ray or pulmonary function tests might be recommended.

What you can do

Lump on Shin:

  • See a healthcare provider for an evaluation. They may recommend imaging or a biopsy to determine the nature of the lump.
  • Avoid any activities that might irritate the area further.

Bone Pain and Fatigue:

  • Schedule an appointment with your doctor to discuss these symptoms, especially given your family history of cancer.
  • Keep a journal of your symptoms using MDandMe to track any changes or patterns.

Cough and Smoking:

  • Consider reducing or quitting smoking to see if it improves your cough. There are resources and support groups that can help with smoking cessation.
  • Stay hydrated and use a humidifier to help soothe your throat.

What you should look out for

Seek medical attention if you experience:

  • Rapid growth of the lump or new lumps appearing.
  • Severe bone pain or fractures.
  • Significant weight loss or night sweats.
  • Difficulty breathing or persistent chest pain.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What could cause a lump on the shin that is warm to the touch and growing?

A lump on the shin that is warm and growing could be a benign condition like a lipoma or cyst, but it could also indicate a more serious issue such as a bone tumor. It's important to have it evaluated by a healthcare provider, who may recommend imaging tests or a biopsy to determine its nature.


How can a persistent dry cough be related to smoking, and what other causes should be considered?

A persistent dry cough can be a result of smoking, which irritates the airways. However, other causes such as asthma, chronic bronchitis, or lung infections should also be considered. A healthcare provider might suggest a chest X-ray or pulmonary function tests to identify the cause.


What are the potential implications of having a family history of multiple myeloma?

Having a family history of multiple myeloma increases the risk of developing this type of blood cancer, which affects the bones and immune system. It's important to monitor symptoms like bone pain and fatigue and discuss them with a healthcare provider, who may recommend blood tests or imaging for further evaluation.


What steps should be taken if experiencing persistent fatigue and swollen lymph nodes?

Persistent fatigue and swollen lymph nodes can be symptoms of various conditions, including infections or more serious issues like cancer. It's important to consult a healthcare provider for a thorough evaluation, which may include blood tests or imaging, to determine the underlying cause and appropriate treatment.


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