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Forum Name: Bone infections

Question: Mass under rib cage and swelling on righrt side of breast


 desperate4help - Mon Nov 10, 2008 7:41 pm

I am desperately trying to figure out what is wrong with me. Six and a half months ago I woke up one morning with pain under my right rib cage (under where the underwire of a bra goes). I did not go to the doctor the next day because I figured I slept on it wrong. The pain continued and got worse so I made an appointment with a local general practitioner. The doctor did a chest x-ray and a regular x-ray to see if I had a broken rib (even though I did nothing to cause it) but they both came back normal and he said it must just be a pulled muscle. He gave me vicodin and told me to take it to relieve the pain and come back if the pain persists. The pain continued so I went back about a week later and he did lots of blood tests and they all came back normal so he scheduled me for a catscan, hydascan and an ultrasound of my gallbladder. All of these tests were normal too. After all of the tests, I still had the pain so he admitted me into the hospital for observation. They did liver profile tests, lots of other blood tests and released me after 2 days because they had no idea what was wrong with me. When I was released from the hospital the doctor refused to see me anymore because he thought I was just there for pain medicine I guess but I was not. Yes I have been and still am in sever pain but I want the source of the problem fixed. About a week later, when the pain under my ribcage was severe I started swelling on my right side (beside my right breast about 3 inches from my armpit). I always have the pain but it is more severe some days than others and when the pain is severe there is always swelling. My entire side by my right breast leading into my back swells to the size of a grapefruit and it is easy to see how swolen it is through my shirt. So next I go see my mom's gp and she saw me a few times and said she did not know what was wrong with me and she told me to see her nurse practitioner from now on. I started seeing the nurse practitioner and she has seen my side slightly swollen but never swollen as bad as it gets. I have called and tried to get the doctor to see me when my side is really swollen but no one will see me. The nurse practitioner finally decided to do a breast exam one day and said she felt a mass and scheduled me to have a diagnostic mammogram. I went for the mammogram and the tech that did the mammogram said she could not see anything but could definately feel the mass and it was deep and under my rib cage so she sent me to have an ultrasound to see if they could see more. Of course they could find nothing wrong but the radiologist said since both techs felt something that my gp needed to refer me to a surgeon. So the nurse practitioner referred me to a general surgeon last week. I went to see him about a week after my doctor scheduled the appt. In the consultation the surgeon did feel the "mass" as he called it and he said that it was either in the bone of my rib cage or in the cartilidge between my ribs but he still didnt know what it was. He said it was about the size of a quarter and kept saying it was really deep. He wanted to schedule me for another cat scan (even though I had already had one for the same reason 3 months earlier) but I agreed. He said that he felt sure the cat scan would not show anything but he wanted to do it just to be sure and he said that if it showed nothing, he would schedule me for a bone scan as soon as he got the results from the cat scan and he would definately find out what was wrong because I had been dealing with this for so long. Well I had the cat scan on a wednesday and they said they would call me back on Thursday and they did not so I called them back on Friday. I spoke the the surgeon's nurse on Friday and she said that she had not had a chance to talk to the doctor yet but she would talk to him and call me back before the end of the day Friday to schedule my bone scan. I did not hear from them Friday so I called them today (Monday) about lunch time and the nurse said she still had not had time to talk to him but she would call me back before the end of the day. She called me back late this afternoon and told me that since my cat scan was fine (although the doctor told me in his office that he felt like it would be and thats why he needed to do a bone scan) there was nothing else they could do for me. I said what about the bone scan and she said oh no thats not necessary. I have called and asked the nurse to please let me come in to show the doctor how swollen my side is and they say no. They said I have no need for a surgeon I need to go back to my gp (who has no idea what is wrong with me). I have insurance but I have already spent almost $15,000 this year in medical bills and I still hurt daily and have a grapefruit sized lump or swollen area beside my right breast. I don't know what I should do anymore. Please help.
 John Kenyon, CNA - Thu Nov 27, 2008 9:57 pm

User avatar Hello -

It may be time to start from square one. It seems no one has taken this quite seriously other than you, and this is beyond unfortunate. Obviously something is going on, but it is extremely difficult to visualize. It would seem you have some sort of herniating defect in the right chest wall. It may even literally inflate from time to time, like a chronically rupturing bulla on the lung which occasionally herniates or possibly infiltrates into the tissues on the outside of the chest wall (this is usually seen as the result of trauma and is called subcutaneous emphysema). Such a lesion, were it to exist (I'm not sure it's even possible, but at least I'm trying), would have certain qualities. If you could describe the swelling or "mass" in a little more detail it would be helpful. Surely you've felt it, pressed on it, etc. Is it firm when at its most swollen or does it always feel relatively soft and pliable? Does it make any noises when pressed upon? Can it be reduced wth manual pressure?

Any additonal information you can provide may help get us at least pointed in the right direction.

I look forward to hearing from you. Hang in there.
 SuzieQuzie - Fri May 15, 2009 10:34 am

So sorry it took me a while to get back to you. (Its me again...desperate4help). I really appreaciate your help. I lost my password for that account and cannot get it reactivated. The pain is always under my right breast (where the underwire of my bra sits) and when it hurts there, I always have swelling on the right side of my rib cage. It never swells where it hurts, just on the side of my ribs close to my armpit. And where it swells it never hurts. Where it hurts is not swollen but if you press deeply there you will feel a mass. Almost like a cyst you would have in your breast but much bigger. It is hard but it does not move around. It cannot be reduced with manual pressure. I went back to the doctor about 2 weeks ago and she felt that it was swollen and said lots of things make you swell, maybe its too much salt. I don't ever add salt to anything I eat. I am not overweight and seem to be in fairly good health besides this. I am no doctor but I do not think salt has anything to do with this. Also, my pulse rate has started going crazy lately. My resting pulse is like 148 and all the doctor said was take propanolol and would not test to see why this is happening either.
 John Kenyon, CNA - Fri May 15, 2009 3:59 pm

User avatar Hello again --

So sorry you had problems getting back here. It sounds as though things are continuing to be a little weird with that swelling, which does sound more and more like either a cyst or calcium deposit. I am a little concerned about your doctor because a) you're right, this would not have anything to do with salt, which does not cause highly localized swelling like you describe but overall water retention which then finds its way to the lower extremities, so that's not a very good answer; and b) a resting heart rate of 148 deserves some exploration, maybe along with a beta blocker to get it slowed down. That's pretty fast, and while you seem to be doing well (and I'm sure this is unrelated to the swelling) it deserves a closer look!
It might be time for a change in doctors, or at least a frank discussion of what you rightfully expect in terms of medical care. The tachycardia might also warrant a cardiology consult. I don't think it's anything serious, but it's not right, and that's reason enough.

Thanks for getting back here and updating. Take good care of you and stay in touch.
 susanchere - Mon Nov 16, 2009 9:39 pm

I have the "EXACT" same situation...I've gone to 13 doctors, had x-rays, ultra sounds, bone scans, MRI's, Ct scans all kinds of meds.....I was finally diagnosed by Shands with a Bone Lesions----but the thorasic surgeon said it doesn't fall under his area and I can't find "anyone" else to help me that knows anything about this rib thing. I've been told it could be a number of thing-even possibly a chordoma of the chest wall (theres only ever been a few cases of one in the ribs). I was taking pain meds quite a bit, but I've learned what triggers the pain and can manage it most of the time. Its gotten quite large, probably 3x5, it hurts like heart burn or a stabbing pain- enough to make me cry at times. Its starting to effect my wearing a bra because the bra rubs on it. I wish I could find someone in Florida who has knowledge of the ribs and could help me. I don't know if its going to keep growing or whats going to happen to me. It almost seems as though it freaks doctors out when they see it or they'll say its just how I'm proportioned, but it wasn't like this a year ago. Its grown quite a bit and I've taken pictures. It shows on the Ct scans, but is very hard to notice unless the person looking goes over the scan slow. The dr at Shands showed it to me on the scan. I don't know what to do... I even have trouble breathing at times. If you get any answers, Well, hopefully they'll help me too.....
 Tom Plamondon PA-C - Fri Nov 20, 2009 3:10 pm

User avatar Hello,
I might suggest a thoracic surgery to evaluate your case especially if the growth is limiting your ability to breathe.
Take care.

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