title: Cyclist's nodule: no smooth ride.
abstract: A fit and active amateur cyclist was referred by his general practitioner to a surgical oncology outpatient clinic with a slowly-growing perineal mass. Following clinical examination, the patient underwent imaging and biopsy at a tertiary soft tissue tumour centre, which diagnosed perineal nodular induration: a rare, benign tumour caused by repetitive trauma associated with 'saddle sports' such as cycling or horse riding. It is important to consider soft tissue tumours in patients who present with 'lumps and bumps'; they can occur anywhere in the body including the groin or perineum, where it is sometimes referred to as a 'third' or 'accessory' testicle in men. Although unusual, the case emphasises the importance of rapid specialist referral from primary care, and consideration of a patient's occupation and hobbies when formulating diagnoses.
authors.affiliation: Deptartment of Plastic Surgery, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Stoneham
authors.affiliation: Department of Histopathology, Royal Marsden Hospital, London, UK.
authors.forename: Khin
authors.initials: K
authors.lastname: Thway
authors.affiliation: Department of Radiology, Royal Marsden Hospital, London, UK.
authors.forename: Christina
authors.initials: C
authors.lastname: Messiou
authors.affiliation: Department of Sarcoma Surgery, Royal Marsden Hospital, London, UK.
authors.forename: Myles
authors.initials: M
authors.lastname: Smith
mesh_terms: D000368:Aged; D001642:Bicycling / Q000293:injuries*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010502:Perineum / Q000002:abnormalities*; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*