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Suggest Treatment For Cyst In Right Arm

Posted on Fri, 2 May 2014

Question: My son, 36, has a cyst about the size of a ping pong ball on the inside of his right arm. Should he go to a neurologist for removal?

Answered by Dr. Ashish Verma (33 minutes later)

Brief Answer: a surgeon can do this excision Detailed Answer: Hi, Thanks for writing to HCM. That cyst can easily be removed by any surgeon. But before its excision get it clinically examined by the surgeon to know about the nature and origin of the swelling. He may even ask you to get a needle biopsy of the swelling if he feels it is needed or an ultrasound of the region. I dont think that there will be any damage to the nerves and blood vessels in the process unless the swelling is arising from one of them. But will usually get cleared by physical examination and needle biopsy or usg. Hope i had been helpful. Regards Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (23 hours later)

Thank you, Dr. Verma: When I said this woman was a Physician's Assistant, I didn't know that she is a Certified Physician's Assistant who has been doing this type of surgery for 14 years. I was told that she is legally qualified to do this surgery without a physician's supervision because she has completed her training to be a doctor, but she has not completed her residency. Does this sound correct to you? I am going to talk to her on the phone tomorrow to find out exactly what she is going to do to my son's arm. I will suggest that she take a needle biopsy or an ultrasound. We haven't received the results of the mark the PAC took off my son's back on Tuesday yet. I will ask the PAC about that tomorrow. The dermatologist thinks it is Melanoma, but she said they removed it early, so there should be no problems. I guess we put our lives in doctors hands. My mom died from Melanoma when she was 58. He removed a dark, oval growth about an inch in diameter from her back 40 years ago and didn't take a biopsy!. She died 3 years later. I had breast cancer in 1986, and my sister-in-law had Melanoma 5 years ago. So, my son has it on both sides of our family. Needless to say, I'm nervous about this, but I just have to have faith and pray a lot. Thank you very much for your advise, Doctor XXXXXXX I really appreciate it.

Answered by Dr. Ashish Verma (1 hour later)

Brief Answer: axilla is a XXXXXXX area Detailed Answer: Hi, If she is having experience of 14 years and she is fully confident that she can excise that swelling safety, then i don't thing there will be any problems. Because axilla is a XXXXXXX area with lots of major vessels and nerves are there in that area, so a person has to be experienced and confident. But I would do at least a needle biopsy before going for the excision. And after excision send the entire mass to histopathology to rule out any malignant tumours. Have faith, things will go fine. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (2 days later)

Thank you, Dr. XXXXXXX By histopathology do you mean a regular biopsy or is there something else involved? Also, if the mass is excised with a little tissue around it, what is the reason for the needle biopsy? If this is just a cyst, and there is a "root" involved, how is that "root" removed without breaking it and leaving some of it inside to grow back? XXXXXXX

Answered by Dr. Ashish Verma (5 hours later)

Brief Answer: its the same Detailed Answer: Hi, Histopathology is same as biopsy where the entire mass is sent for evaluation after ecxision. Needle biopsy before excision is helpful in planning the excision. If it comes benign then only the mass can be excised. If its suspicious or malignant than a more extensive excision will be needed, as generally in the axilla, due to abundance of vital structures in the proximity, excision of the mass with a layer of tissue all around is not possible in each direction. So prior preperation is very helpful. If it is a simple cyst, then cyst don't have any root. They just have a feeding vessels at the base, which needs to be securely ligated and divided to prevent bleeding. If a cyst is excised completely with its capsule or cyst wall, then there is no question of recurrence. If a part of cyst wall is left behind, then there are chances of recurrence. And if your physician assistant with 14 years of experience does not know this all, then I am afraid to say, that you should go to a qualified surgeon. Regards Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ashish Verma (2 days later)

Thank you, Dr. XXXXXXX No more questions now. XXXXXXX

Answered by Dr. Ashish Verma (29 minutes later)

Brief Answer: Welcome... Detailed Answer: Hi, If you have no more questions, then please close this discussion and rate the response. Regards Dr. Ashish Verma

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Prasad