Patient: My daughter has a bump on her forehead that has been there for over six months. There is a small hard bump but then there is also fluid like swelling around the bump that spreads from her upper forehead to right above her right eyebrow. It is mostly noticeable when she raises her eyebrows. She seen a doctor two months ago who said that it looked okay but it appears to have gotten bigger. I am concerned about what could cause such a bump and fluid to appear in her forehead. Please help.
Doctor: Hello,Thanks for your query and the image you have sent.Read and understood the history.(To recapitulate: child – bump on the forehead for 6 months – small hard bump with fluid like swelling around – on right forehead up to right eyebrow – mostly noticeable when the eyebrow is raised – seen by a Doctor 2 months ago – but appears to have gotten bigger – wants to know the cause.)The most probable reason I can think of after seeing the picture and reading an elucidate history is:This may be enlargement of the frontalis muscle, hence getting prominence on raising the eyebrow and getting limited up to the eyebrowThe hard bump can be from an organised old hematoma or from the bone of the skull itself- difficult to say without actually palpating it.I would advise you the following:MRI would help the most to tell us about what the lump with its components may be.Get a consultation of a Pediatric Surgeon, who on clinical evaluation, physical examination and correlation with MRI or whichever investigation will be in a position to tell the best possible diagnosis and treatment.I hope this answer helps you to get the best possible diagnosis and a plan for further treatment.
Comments / Follow Ups
Patient: She did fall about eight months ago and got a big bump on the right side of her forehead, but I would assume this is unrelated as it has been so long. Not sure how it could be the frontalis muscle as its only on one side and it is more rounded in shape. Doesn’t look nor feel muscular, feels fluidlike, squishy even. I already have an appointment set up for her, but wanted some peace of mind if possible before going in. I hoped not to pay just to have someone tell me to see a doctor.
Doctor: The history of fall is 8 months ago,. This gave a big bump on the same area. There are two frontalis muscles, one on each side. The anatomy of the muscles and the covering of the skull bone is such that it is possibly an enclosed seroma-like thing giving the appearance of fluidlike, squishy appearance.
MRI would definitely help to get a correct diagnosis.
Will be happy to get a feedback.