A 24-year-old woman came to the office with a nearly golf ball-sized mass in her armpit. The physician, who was not directly seeing patients but overseeing residents, was presented with the case by one of the residents. The woman had been experiencing the mass for about five days, with pain initially but it had subsided to a 4 out of 10. The mass was mobile, round, well-circumscribed, and somewhat tender.
The physician, upon examining the patient, found that the mass had some suspicious features but also some benign features. He was puzzled as the patient was a healthy individual without any known risk factors. He asked a series of questions about her health history, family history, recent illnesses, injuries, blood work, and vaccines.
The patient revealed that she had recently received a COVID-19 vaccine in the arm where the mass was located. The physician then realized that the mass could be a result of the vaccine, as one of the side effects is swollen lymph nodes. The swelling is actually a good sign as it indicates the immune system's response to the vaccine.
After two weeks, the lymph node and the mass disappeared, confirming the physician's diagnosis. The case underscores the importance of a thorough history and physical examination in making a diagnosis.
1. A 24-year-old female presented with a nearly golf ball-sized mass in her armpit.
2. The patient had been experiencing pain for about five days, which had since subsided but was still a 4 out of 10 on the pain scale.
3. The mass was about 2-3 centimeters in size, mobile, round, and well-circumscribed.
4. The mass was somewhat tender but not very superficial.
5. The doctor was trying to distinguish between a potentially dangerous mass and one that was more benign.
6. The patient was healthy with no known family history of cancers or autoimmune diseases.
7. The patient had no recent illnesses, injuries, or vaccinations that could have caused the mass.
8. The doctor decided to proceed with a watchful waiting approach, observing the mass for changes over the next two weeks.
9. The patient had received a COVID-19 vaccine three days prior, which could have caused the swelling in the lymph nodes.
10. The doctor advised the patient to wait four to six weeks after receiving the vaccine before getting a mammogram.
11. Two weeks later, the patient returned and the mass had disappeared.