A Growing Bump: Seeking Answers for a Persistent Arm Mass
For the past 3 to 4 years, I’ve noticed a troubling development on my upper arm. I’m currently 18, and my mom first observed that the area was swelling noticeably, while the rest of my body remains the same. Since then, the growth hasn’t slowed down. Around two years ago, my mom took me to a coolsculpting clinic; she was curious about the mass on my arm. The staff, including both the receptionist and a doctor, were taken aback by how quickly it had expanded. They even reached out to other medical professionals in hopes of finding answers for me, but nobody was able to provide an explanation. At that time, the mass was only half its current size. Over the last three years, I’ve maintained a weight between 170 and 190 pounds after starting birth control, with my body fat distributed evenly—except for my arms. Standing at 5’5”, I was once considered for a diagnosis of polycystic ovary syndrome (PCOS), but that was possibly misdiagnosed. This growth on my arm has continuously caused issues like dark discoloration and recurrent rashes or infections. The only effective method I’ve found to manage the dark spots is using a harsh skin scrubber, which requires scrubbing vigorously for five minutes, sometimes followed by waxing to remove layers of thickened skin. Could this mass be breast fat? My mom speculates it might be, especially since I do have a larger bust, but it seems illogical since my breast size hasn’t changed over the past two years, nor has my weight. The growth on my arm remains soft and jiggly, surrounded by loose skin, forming a noticeable bump that even created a crease on my arm. I’ve consulted a doctor who suggested that it might be lymphoma, but they were also uncertain. I’ve committed to a consistent workout routine, including dumbbell exercises and upper body workouts almost daily for five months, yet I haven’t seen any reduction in size. Regardless of swimming and playing rhythm games—activities that engage my arms—the only observable difference is that my dominant side is marginally smaller. I realize now that targeted fat loss isn’t feasible through exercise alone, leaving me feeling rather helpless. I can’t help but wonder if it’s tied to puberty and hormonal changes, as I’ve been genetically unfortunate, resulting in localized fat accumulation. However, it baffles me that this growth appeared randomly during my teenage years and has continued expanding, especially since I haven’t gained weight in over a year. I’m unaware of the costs associated with plastic surgery in Canada, and given that I’m a young adult currently unemployed, that’s not a viable option for me. Are there any alternatives to address this issue without undergoing surgery, or will I have to live with this insecurity until I can save for a procedure? (Additional details: I’ve never smoked or used tobacco products, and the only medication I take is the prescribed birth control called "Alesse." Now weighing approximately 195 pounds, my diet primarily consists of fruits like apples, bananas, blueberries, and cherries, along with avocado, eggs, and honey on toast. I generally eat healthily, depending on my parents' cooking, having 1 or 2 meals and a snack daily. I enjoy drinking tea and exercise 2-3 times a week for about 10-20 minutes. Since turning 18, I consume alcohol infrequently, approximately 3-4 times a month, and my recent blood tests showed perfect health results otherwise.) I’m in need of guidance and support on this! (。•́︿•̀。)
Answers (1)
9/5/2025, 10:40:46 AM
OpenHealth AI
Main Points
You’ve been experiencing a persistent growth on your upper arm for several years that has caused you physical and emotional discomfort. There are concerns about the nature of this mass, and you’re seeking non-surgical options for management.
Explanation
The mass on your arm could be several things, including a benign growth like a lipoma (a lump of fatty tissue) or other conditions. Given that it’s been present for several years and is changing, it's important to have a clear understanding of what it is. Hormonal changes during puberty can sometimes lead to abnormal fat deposits, but it's unusual for a mass to develop and grow so noticeably over time. Additionally, dark discoloration and rashes could indicate irritation or another skin condition.
The consultation about lymphoma raises some concerns, and while it might seem daunting, lymphoma tends to present with a combination of symptoms such as swollen lymph nodes elsewhere, weight loss, or fever. Your doctor should be able to clarify this through appropriate tests, including imaging studies or a biopsy if needed.
Next Steps
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Follow-Up with Healthcare Provider:
- Schedule a follow-up appointment with a healthcare professional specialized in dermatology or a general practitioner. It's crucial to pursue a definitive diagnosis through imaging (like an ultrasound) or biopsies if warranted.
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Monitor Symptoms:
- Keep track of any new symptoms or changes in the mass, including pain, changes in size, or additional skin changes. Documenting these can aid your doctor in evaluating the situation.
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Manage Skin Discomfort:
- Instead of harsh scrubbing, try to keep the area clean and moisturized. Use gentle cleansers and consider consulting a dermatologist for creams that might help with the dark discoloration and skin irritation.
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Explore Non-Surgical Options:
- Inquire with your healthcare provider about non-surgical management strategies, such as corticosteroid injections, which can sometimes reduce the size of benign growths depending on the type, or physical therapy options to help improve your arm's overall appearance.
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Lifestyle Adjustments:
- While exercise may not directly target the mass, maintaining a healthy lifestyle can improve your overall body composition. Continue your workouts, prioritize a balanced diet, and aim for consistent hydration.
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Support System:
- Since this situation has caused you emotional distress, consider talking to someone about these feelings. This could be friends, family, or even a counselor, as emotional support can make a significant difference.
Your concern is completely understandable, and seeking answers is a positive step. Remember, you are not alone in this, and there are potential avenues to explore that could help manage your situation better. If you have any more questions or need further guidance, feel free to ask.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.