My best friend ChatGpt said this.
" That's actually a reasonable question, and the answer depends a bit on exactly where the lump is and what it feels like. If someone described it exactly that way, here's what I'd tell them:
Start with either a primary care physician or a urologist. If it's truly in the perineum (the area between the scrotum and the anus), a urologist is often the most appropriate specialist for men. A primary care doctor can also evaluate it and refer to the right specialist if needed.
Based on the description, there are several possibilities:
Scar tissue or fibrosis from repeated saddle sores or prolonged cycling. This is actually fairly common in avid cyclists. Repeated pressure can lead to firm nodules or thickened tissue.
An epidermoid (sebaceous) cyst or other benign skin cyst.
A lipoma, which is a soft, rubbery, benign fatty tumor.
A chronic inflamed sweat gland or blocked gland.
A perineal nodular induration ("cyclist's nodule"), a benign condition caused by repeated pressure and friction from bicycle saddles. This would fit the history of lots of cycling surprisingly well.
Less commonly, an abscess, enlarged lymphatic tissue, or, rarely, a tumor.
The fact that it's:
about the size of a dime,
flattened,
under the skin,
and apparently associated with a history of severe saddle sores
makes a benign pressure-related problem more likely than something dangerous. That said, you can't tell for certain just by feeling it.
Who probably isn't the best first choice?
Dermatologist: Good if it's clearly a skin lesion or cyst, but many perineal lumps aren't purely skin problems.
Proctologist/colorectal surgeon: More appropriate if the lump is close to the anus or associated with bowel symptoms, hemorrhoids, fistulas, or pain during bowel movements.
General surgeon: Usually only after another doctor determines it needs removal.
What will the doctor likely do?
Usually they'll:
Examine the area.
Determine whether it's attached to the skin or deeper tissues.
Decide if an ultrasound is needed (often the first imaging test) or occasionally an MRI if it's deeper.
Recommend observation or removal if it's painful, growing, or uncertain.
When should someone get it checked promptly?
They shouldn't wait if it:
is rapidly growing,
becomes red, hot, or very painful,
starts draining pus or blood,
causes numbness or urinary problems,
or is fixed, hard, and doesn't move.
Otherwise, if it's been there for months or years without changing, it's less urgentbut it's still worth having examined because many benign lumps can be identified quickly with a physical exam.
If I had to guess from that description alone, a cyclist's nodule (perineal nodular induration) or scar tissue from repeated saddle sores would be high on my list, but only an examination can distinguish those from a cyst, lipoma, or another type of mass."
I would try to go on the dr Pimple Popper show so a bunch of people could see.
