Cyclist's Nodule

Discussion in 'Cycling Equipment' started by Jim Wilson, Mar 2, 2003.

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  1. Jim Wilson

    Jim Wilson Guest

    Two months ago, I noticed a marble sized lump in my groin on the inside of my left leg. There was no
    pain or other symptom, it was just there. When riding, if I paid attention, I knew it was there, but
    there wasn't any discomfort. I'm a 57 year old, 190 pound guy who has ridden about 3-4000 road
    miles/year for the last 15 years. I usually ride several recreational centuries a year, the Death
    Ride and otherwise 25-60 miles a pop. Maybe once a week in the local hills (sea level, 2000 feet
    vertical) but nothing competitive, except against myself, and nothing really obsessive.

    Uncertain about what this marble was, and unable to find help online, I scheduled one of my
    occasional physicals which started with my doctor asking "Why are you here? You don't usually come
    in voluntarily". He identified the marble as a 6-8mm roundish nodule just under the skin in the left
    perineum area. He didn't think it was prostate cancer (wrong location and shape) but beyond that
    didn't know what it was. Recommendation: have an ultrasound test to find out if the nodule was
    cystic or solid.

    OK, I join 42 women waiting to have their basketball size lumps ultra sounded. A very professional
    lady technician explained her process and showed me the pictures returned by the machine was but
    wasn't able to answer the question - what was the nodule? She couldn't find a blood supply to it,
    which I took as good news. After the radiologist and my doctor discussed the test, my Doctor thought
    that there might be a fatty center, but beyond that he knew it wasn't contributing anything and
    recommended it be removed.

    Off to see the surgeon. He didn't have any idea what the nodule was either. Easy solution tho,
    outpatient surgery the next day to extract the little puppy and hand it over to a Pathologist who
    could tell me for sure that it was benign and could at least hang some names on it. I hadn't been
    able to learn much about this condition mousing around because I didn't know the right words to
    describe it.

    Armed with the words my various Doctors used, I found a short list of info bits.

    The best brief description was a 1997 Usenet posting: "There is a similar condition known in
    professional cyclists. It is basically a fibrous growth due to repetitive stress to the subcutaneous
    tissue. One might want to compare it with a callus. In some riders two of these lumps appear in the
    perineum that look like a second pair of testicles (talking about cyclist's impotence ... ;-) ).
    Still I think you should see a doc to rule out an infection.
    --
    Didi Burki MD, Berne/Switzerland"

    <http://www.ualberta.ca/htbin/lwgate/PATHO-L/archives/patho-l.archive.1999-11/subject/> search
    for cyclist

    <http://link.springer-ny.com/link/service/journals/00105/bibs/0051010/00510763.htm> use Google's
    translation service

    I found a summary of this article in English but can't locate the link now. "Vuong P.N, Camuzard P.,
    Schoonaert M.F., Perineal nodular indurations ("accessory testicles") in cyclists. Fine needle
    aspiration and pathologic findings in two cases. Acta Cytol 1988;
    32:86-90." Acta Cytol 1988 Jan-Feb;32(1):86-90

    Perineal nodular indurations ("accessory testicles") in cyclists. Fine needle aspiration cytologic
    and pathologic findings in two cases.

    Vuong PN, Camuzard P, Schoonaert MF

    Laboratory of Pathology and Cytology, Bievres, France.

    The cytologic and histologic findings from two cases of perineal nodular indurations observed in two
    cyclists are reported. These lesions, also referred to as "accessory testicles" or "third testicle"
    or "ischial hygromas" of cyclists, consist of a localized aseptic area of necrosis with pseudocyst
    formation involving connective tissue in the superficial fascia of the perineum. These histologic
    findings, which were seen in the subsequent surgical specimens in these two cases, were reflected in
    the fine needle aspiration findings. The aspirates contained few cellular elements, mainly a few
    vacuolated histiocytes, against a background of fibrinous material. These indurations, which develop
    as a result of repeated, chronic microtrauma to the perineum impressed by the vibration of the
    saddle of the bicycle, constitute an authentic handicap for the professional cyclist and are a
    contraindication to cycling for amateur cyclists.

    Arne Baker mentioned the condition on p182 of his book "Bicycling Medicine".

    I'm sharing this in the hope that another rider who finds a surprise guest may have a little better
    idea of what's happening.

    Keywords: fibromatosis nodule induration ischial hygroma fibrous perineal "cyclist's nodule" "deep
    saddle sore".

    Jim Wilson
     
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  2. A friend of mine (a doctor and cyclist like myself) had one of these removed.
     
  3. I used to get something like you describe, I think, these and had them removed. I think mine were
    sebaceous cysts . Gary Jacobson Rosendale, NY

    "Gearóid Ó Laoi, Garry Lee" <[email protected]> wrote in message
    news:[email protected]...
    > A friend of mine (a doctor and cyclist like myself) had one of these removed.
     
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