Could my recurring hard rib lump be cancer?

Question

Hello doctor,

About 16 weeks ago, I noticed a hard, round lump on my lower right rib. During the first week, I drained it myself, and it contained pus, but for the past 15 weeks, there has been no further discharge. Instead, the lump has become firmer and appears deeper. Externally, it has a hard surface, and the core feels solid, roughly the consistency of an apple. It seems rooted, with the core extending about 1.5 to 2 cm into the tissue.

Occasionally, I have been able to gently twist out the core, which is somewhat uncomfortable but less painful than expected. The core is similar in color, thickness, and texture to spaghetti, while the surface is slightly wider, very hard, and darker in shade. The lump keeps recurring.

I am concerned it may be something serious, particularly because cancer has affected every female on my mother’s side, including skin, breast, and cervical cancer. I would like to ensure it is not cancerous. I also have images and video documenting the lump and the material I have been able to extract.

I would greatly appreciate any guidance.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Thank you for expressing your concern.

The most likely diagnosis is a recurring epidermoid cyst or a big keratin plug, not skin cancer.

Your description of a hard, round lump with a dark, firm exterior and a stringy "spaghetti-like" center indicates keratin. Epidermoid cysts frequently contain thick, white or yellow keratin, which appears stringy when expressed. When you press or twist it out, you're most likely removing the contents rather than the cyst wall. If the capsule remains beneath the skin, it refills and recurs, explaining why it continues returning.

The fact that it has been present for 16 weeks, is firm, can be partially expressed, and does not rapidly spread or ulcerate reduces the likelihood of aggressive skin cancer. Skin tumors rarely develop a detachable core like this.

Features that might warrant immediate evaluation include:

Rapid growth.
irregular borders.
Persistent bleeding without manipulation.
Non-healing ulcers.
Uneven colour shifts (black, brown, or red).
Severe or growing pain.

Why does it feel deeper now?

Repeated lancing or squeezing can result in inflammation, scarring, and thickening, making the lump seem more anchored and rigid. Frequent manipulation increases the danger of infection.

Recommended management:

Do not try to extract it yourself.

Have a clinician inspect it in person.
The definitive treatment for a recurring cyst is modest surgical excision to remove the entire capsule under local anesthesia.
If inflamed, antibiotics may occasionally be required.
Although you have a family history of cancer, your current symptoms do not indicate breast, cervical, or skin cancer.

Recurrent and deep lumps (1.5-2 cm) should be checked in person, even if not urgent. A general practitioner or dermatologist can examine it and, if benign, remove it completely. Based on your description, it does not appear hostile, but it is persistent and unlikely to resolve without proper eradication.

I hope this helps.

Thank you.