Advice about a lump

The scene

A 28-year old man saw his GP, who was an MDU member, complaining of a lump in his left thigh. The GP examined the lump, which was about 3cm in diameter, and diagnosed a lipoma.

No further details about the lump were recorded in the medical records. According to the GP, the patient was told to reattend if the lump changed, particularly if it increased in size or became painful, although there was no record of this advice in the medical records.

Over a period of time the patient saw the GP on a number of occasions with problems unrelated to the lump. Then, after two years, he saw another GP, also an MDU member, to say that the lump was getting bigger.

The second GP examined it and found that it was now approximately 6cm in size. Given the history of increasing size of the lump, the GP referred the patient to a general surgeon.

The patient was reviewed in clinic six weeks later by the surgeon, who was concerned that the lump might be malignant. The surgeon arranged a biopsy of the lump, which showed a low grade sarcoma. MRI scans did not reveal any metastatic disease. The patient was treated with surgical resection and radiotherapy.

Two years later, the GP who had first seen the patient received a letter of claim. It was alleged that there had been a failure to advise the patient to reattend in relation to the lump. It was also alleged that when the patient attended with unrelated problems, enquiry should have been made about the lump, and that had this occurred, the sarcoma would have been diagnosed earlier and less extensive surgery would have been required.

The outcome

The MDU instructed a GP expert and an oncology expert. The GP expert advised that at the time of the first consultation, the diagnosis of a lipoma was reasonable. Given the GP's statement that he had also advised the claimant to reattend if the lump changed, the management on this occasion was reasonable.

The GP expert also advised that, given the diagnosis of lipoma, it was reasonable for the GP not to have enquired further about the lump when the patient had attended with other concerns.

The oncology expert advised that it was likely that the grade of the sarcoma would have been the same if it had been diagnosed two years earlier, and that the extent of surgery required would have been similar even with earlier diagnosis.

In view of the supportive expert advice, the MDU served a letter of response denying liability on behalf of its member, and the claim was discontinued.

This page was correct at publication on 17/12/2010. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.