Is my painless, localized lump an adipose tissue?

Hello doctor,

I am contacting you regarding a question I have been thinking about for a while and would like an expert opinion on how to best move forward with this. Before I begin, let me explain the background story, so you have better context. Earlier this year, I went to a doctor for a lump slightly above my right knee. It was not painful, nor do I think it was growing, but I had observed it for three to five months, and it did not go away. So I went to the doctor for a first evaluation. Please check the picture attachment. The first lump was in area 1. This is the response of the doctor after the first evaluation:

"31-year-old male presenting due to lump on the lower right thigh which has been present for at least three months. It is non-painful and non-disturbing to the patient. The patient does not believe it has grown, and there is no underlying trauma. The patient does not smoke. Right thigh: About 2 cm above the knee joint, a hard-to-delineate resistance is palpated that is non-fluctuating and non-tender. No local redness, swelling, or heat increase. Smooth surface, about 7 cm large, does not disappear with the tension of thigh muscles, more obvious with flexion of the lower leg, no pulsation."

After this evaluation, the doctor told me she did not know what it was, so to be sure, she ordered an MRI scan of my right thigh to rule out malignancy or cancer. So three days later, I had an MRI of my right leg. First, they put a tube-like thing on the area of my lump and taped it. Then I went under the MRI machine. This is the result of the MRI images stated by the radiologist:

"At the marker's location, there is only adipose tissue. Thus, no tumor or delineable lipoma can be detected. Nothing remarkable otherwise".

Four days after that, I met with the orthopedist, who confirmed that only fat was found on the area of the lump. Hence no malignancy was there, and everything was fine.

As you can imagine, I was thrilled that nothing dangerous was behind this lump. But after this incident, I have become a bit hypochondriac. I have been touching and feeling my body, especially my right leg, to find any other lump or anything else. There is another lump of almost similar nature (I think slightly bigger) in area 2 in the image. So it is in the same leg and slightly above it. Its nature of it is similar to the area. It does not hurt, nor do I think it has become bigger.

I have two questions, and I would like that you answer me in detail to ease my anxiety:

1) Given that the lump on area 1 has been investigated and an MRI scan has been taken for that spot and concluded that it is only fatty tissue and, therefore, benign, is it safe to assume that the lump on area 2 is also the same? What should my stance be regarding this?

2) Could you please explain a little bit about MRI scans? Given that they took an MRI scan with the target on area 1 of my leg, does this mean that my entire leg has also been scanned? And hence if that is the case, they would have spotted the lump in area 2, and therefore if they spotted it and saw nothing noteworthy, everything is fine.

Do you think I should also see a doctor for evaluation on area 2? Or am I overreacting? Please be detailed and help me with the recommended steps to take.

Hello doctor,

A little more context so you have a better understanding of the situation. Yes, from what I understood the purpose of the MRI scan was to rule out malignant origins of the Lump, particularly soft tissue sarcoma. The reason for that was because the doctor upon first hands-on evaluation estimated that the lump was around 7 cm in size, and according to Swedish law, any lump more than 5 cm in the leg must be investigated to rule out malignancies. Fortunately, the results of the MRI turned out to be only fat tissue in that area (area 1). In particular, this is what the response from the radiologist said at the location of the marker, there is only adipose tissue. Thus, no tumor or delineable lipoma can be detected. Nothing remarkable otherwise. So according to the radiologist, there was no evidence of a tumor nor any evidence of Lipoma, there was only a collection of fat tissue. I had a meeting with an orthopedist five days after that to discuss the results, and she confirmed that the lump was simply fat tissue and assured me that there were no signs of malignancy in the MRI scan. The fat tissue according to her was "unevenly distributed", hence it gave the resemblance of a lump. I have followed your instructions and contacted my physician today and informed her about the lump in area 2. She told me that in the MRI images taken only 1 lump was seen, and that's the one in area 1. She told me she could not see any other lumps. I forgot to ask her if the entire thigh was scanned or if only the area above my knee was scanned. But she booked an appointment with me for the start of the year upon which she will have a hands-on evaluation of area 2. With the additional context as explained above and given your wealth of expertise and experience in this field, do you think that area 2 is something I should worry about? Or, is it most likely to be fat tissue just like in area 1? Your in-depth opinion and explanation would be greatly appreciated.

Hello doctor,

Here is an update on my situation. so yesterday I visited my physician to address the concern on area 2. She did a hands-on examination of area 2 and palpated it with her hand at multiple angles. She then had me lying down and lifting my leg so she could further palpate it. She told me that I could not find any deviation at all, from what I could see your leg is fully normal. She then proceeded to tell me that it was most likely also fat tissue, like area 1. I further asked her about the MRI image for area 1 and whether or not that image encapsulated the entire upper thigh including Area 2. Upon her double-checking the images, she told me that indeed the entire upper thigh was also included in the MRI scan (which encapsulated area 2) and that it was completely normal. She told me that there were no grounds for malignant suspicion as per hands-on examination along with the first MRI scan and that I should stop thinking about it. What are your thoughts on this?

Please advise.