Lump on Tortoise Head/Tumor? Cyst? Abscess?

COmtnLady said:

I only agree a little bit with the Vet's statement that the swelling will go down as it heals. There will be residual scar tissue that stays. Yes, it will be less/lower than what we are seeing at the moment, but scar tissue is stubborn and without the normal skin's blood supply and such, a scar stays for the rest of a lifetime.

The constant re-irritating needs to be reduced. In another location it could be bandaged, but torts pull their heads in too many times per day. These next few ideas are just brainstorming, so anything needs discussed a lot with the long-term members before being done, because there is a lot I don't know about tortoises.

Filing the leading edge of the shell would be a good idea, but it won't grow back much, and will always have that same general shape from here on out.

Could some silicon be "painted" over that front edge to "pad" the edge?
Or several layers of fingernail polish (which would wear off after a few weeks)?

Create a mini "collar of shame"? (Might be impossible to situate so it doesn't cause more problems rubbing somewhere else...)

An old-fashioned corn plaster, the type that pads and has a hole in the center, though the moleskin type could be adapted with some creative scissor work. It will get rubbed off very easily (which could become your tortoise's new hobby), but might provide enough of a break from irritating the open wound that it helps.




@zovick , @Tom , @Yvonne G , @Markw84 , @Maggie3fan , @wellington




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So tonight I used some heavy duty tape and a piece of gauze wrapped around the edge of his shell to pad. I was very careful to only let the tape stick to his shell and not the thin delicate skin nearby. I then applied SSD, and it does seem to be slipping over the tape easier than it was his shell. It is very smooth, and the gauze will add a touch more padding.

I would file, but I dont think it would help much. That part of his shell is already pretty rounded naturally. I don't really care about how his shell looks, only that he starts to heal.

Yeah I had already previously discussed the scaring with the vet, we were specifically discussing the excessive granulation tissue in that email. I know it will always be there, and I do not care as long as the raised tissue doesn't continue to cause issues.

Would love to hear any more suggestions from everyone here, but right now I am thinking I just need to be vigilant and try to reduce any repeated trauma.

So a quick update.
I think it's looking okay, but it is definitely hard to say. I feel like the swelling has gone down slightly, but I am honestly not sure.
The tape and gauze has held up well, Hermann hasn't gotten it off yet.

That looks A LOT better! It looks like its actually closing over and healing. Yay!

COmtnLady said:

That looks A LOT better! It looks like its actually closing over and healing. Yay!

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I know!
There's just still so much tissue though. I guess hopefully it starts to reduce a little bit over time so it isn't rubbing as bad.

Here's a small update. I left the first tape and gauze cushion on for about a week. I didn't soak him during this time. I've been applying SSD once daily.
In spirit he is still doing well. He is active and eating and like his usual self.
I think it's looking pretty good. There is still a lot of excess tissue.
I am so tempted to remove the scab and see what is underneath, but I know that is counterintuitive.
I'm keeping the cushion on him but watching his shell closely, I don't want moisture getting stuck underneath.
How do you guys think it is looking?
@zovick

Nellie Rose said:

Here's a small update. I left the first tape and gauze cushion on for about a week. I didn't soak him during this time. I've been applying SSD once daily.
In spirit he is still doing well. He is active and eating and like his usual self.
I think it's looking pretty good. There is still a lot of excess tissue.
I am so tempted to remove the scab and see what is underneath, but I know that is counterintuitive.
I'm keeping the cushion on him but watching his shell closely, I don't want moisture getting stuck underneath.
How do you guys think it is looking?
@zovick

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It doesn't look bad in the top views, but the side views seem to show a lot of redundant tissue growing beyond the border of the original wound (known as a keloid). It might be worth having the vet check that tissue.

Perhaps the excess growth could be cut off and the wound cauterized really well to prevent it from coming back.

Also - soaking is SO important. Not soaking can cause all sorts of other problems. Pull the pad off, soak him for at least a half hour, let it get dry enough to stick and put a new one on him. Really, it needs done at least every-other day.

I support what Zovick just said - there is a lot of proud flesh. It seems to be healing over very well, but will that lump of scar tissue be a constant irritant, rubbing open again and again? It might be best to see about getting it taken off now rather than "fiddling" with it for years. If it were located elsewhere you might be able to take care of it yourself, but so close to the eye and other sensitive areas on the head, it might be good to just have the vet deal with it, as Zovick said. Cauterizing it would only set your healing back a few weeks, as opposed to having it be open again, or rubbing and getting irritated again.




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zovick said:

It doesn't look bad in the top views, but the side views seem to show a lot of redundant tissue growing beyond the border of the original wound (known as a keloid). It might be worth having the vet check that tissue.

Perhaps the excess growth could be cut off and the wound cauterized really well to prevent it from coming back.

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That's what i will likely do. I have emailed the vet and he said there is a chance that tissue will regress once the inflammation comes down, so i am going to give it another week or two, then likely make an appointment at a specialist in Virginia if there is no change. As is, as long as he is wearing the bandage, there is no trauma from the shell, so i feel safe to wait and see a touch longer.

COmtnLady said:

Also - soaking is SO important. Not soaking can cause all sorts of other problems. Pull the pad off, soak him for at least a half hour, let it get dry enough to stick and put a new one on him. Really, it needs done at least every-other day.

I support what Zovick just said - there is a lot of proud flesh. It seems to be healing over very well, but will that lump of scar tissue be a constant irritant, rubbing open again and again? It might be best to see about getting it taken off now rather than "fiddling" with it for years. If it were located elsewhere you might be able to take care of it yourself, but so close to the eye and other sensitive areas on the head, it might be good to just have the vet deal with it, as Zovick said. Cauterizing it would only set your healing back a few weeks, as opposed to having it be open again, or rubbing and getting irritated again.




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Yes previously I was soaking him daily, and was so until I applied the bandage, and someone recommended holding off on soaking for a few days. I also misspoke, he was allowed to soak twice during that week but in very shallow water to avoid soaking the bandage, and he got a nice long soak on Saturday after I removed the original wrap.
He also has access to clean water always, and soaked mazuri every day.
I'll likely wait another week or two, but yes another vet visit is likely in his future. I have been emailing the vet, so i feel safe to wait and see a touch longer, but i will take him if it doesn't start to reduce. I plan on taking him to a specialist in Virginia rather than the ER this time. They are very well known, and would be able to accommodate rechecks if needed, which the ER cannot.

A little late but I normally use chlorhexidine to clean wounds, especially on myself. I've personally found it to work better than Neosporin and it doesn't need to stay on. Doesn't sting or irritate and you can just rinse it off after washing. I have a tendency to stab my left hand a lot from cooking and it's done wonders for those wounds, heals quick and minimal scarring. Just have to be careful not to get it in their eyes.

tempest979 said:

A little late but I normally use chlorhexidine to clean wounds, especially on myself. I've personally found it to work better than Neosporin and it doesn't need to stay on. Doesn't sting or irritate and you can just rinse it off after washing. I have a tendency to stab my left hand a lot from cooking and it's done wonders for those wounds, heals quick and minimal scarring. Just have to be careful not to get it in their eyes.

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We use chlorahexadine at the hospital, I just didn't have any. I'll have to get some. We usually dilute it before using it on wounds or skin infections.
And we do the same thing, if anyone gets bit, especially if there is a puncture, the first thing we all grab is clorahex and we use it on ourselves straight. Ive filled curved syringes and used it to flush out deep punctures or scratches before finishing my shift and heading to urgent care
I'm in small animal GP right now, but I'd love to get some experience in exotics one day, maybe once I am credentialed. It's hard to break into in my area.

Nellie Rose said:

We use chlorahexadine at the hospital, I just didn't have any. I'll have to get some. We usually dilute it before using it on wounds or skin infections.
And we do the same thing, if anyone gets bit, especially if there is a puncture, the first thing we all grab is clorahex and we use it on ourselves straight. Ive filled curved syringes and used it to flush out deep punctures or scratches before finishing my shift and heading to urgent care
I'm in small animal GP right now, but I'd love to get some experience in exotics one day, maybe once I am credentialed. It's hard to break into in my area.

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I love chlorhexidine ever since I found it. I got nail fungus on my toenail several years ago and nearly lost that entire toenail before I realized what it was, never had nail fungus before. Googled how to get rid of nail fungus and google searches said I needed laser surgery and it would take up to 12 treatments, thousands of dollars and a year. I said HECK NO! Took out my bottle of hibiclens, use an old toothbrush to brush it on twice a day. Fungus was gone in a week. I've also used it on random skin irritations where I could not find the cause of them, slapped some hibiclens on and washed it off, it stopped itching. It's some great stuff, I always have a bottle around in case I need it.

So i changed my mind this morning.
I took Hermann to Stahls Veterinary in Virginia, I drove 4 hours round trip.
I don't know much yet but there are a lot of possibilities. Somehow this was the first time I saw his radiographs, and yeah I am also concerned about the lung space. There's a chance of a space occupying mass.
He's also lost some weight, about 8% of what he was before. The doctor felt he's had some muscle wasting, which could be due to him being in a smaller enclosure since the surgery, or something worse. He is definitely still eating appropriately.
The doctor said his overall demeanor is a good sign, and that a really sick tortoise likely wouldn't be as outgoing. I have never described him as outgoing, but definitely active, he would not sit still at all.

So as far as the plan- I okayed repeat blood work, a biopsy of the excess tissue to send to a pathologist, and a CT scan. The doctor is also going to remove the scab and look for any signs of further infection. They'll flush it with chlorahex and get him cleaned up.
The plan going forward depends on what we find both on the biopsy and the CT.
I'll be on a payment plan to cover it all, and thankfully they offer some small discounts to veterinary professionals which is a huge help.

He'll be staying at the hospital until 7PM tomorrow to accommodate my work schedule, I'll be starting a 20 hour shift tonight.

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The doctor called me while I was typing what was above.
Hermann got the biopsy under light sedation and has been recovering well. I'll get results in a week or two. There's a lot of possibilities but the multiple doctors consulting on his case agree at this point there is a strong possibility this is not an abscess at all, and some kind of growth, ranging from a papiloma to squamous cell carcinoma. If it is cancerous, the doctor said the CT may show if it has metastisised, and if it hasn't we could excise aggressively in attempt to remove it, but I don't want to get ahead of myself yet.
They also performed the CT scan, and the doctor told me that her first impression is that his lung fields are much better than as shown in radiographs, but still small. The radiologist report will come in by tomorrow, Wednesday at the latest.
Blood work is better. Protein is slightly elevated indicating potential dehydration but otherwise the values are looking better. The CBC is not back yet, just the chemistry.

I'll attach the radiographs here so everyone can see why they were so concerning. I work with dogs and cats and even I can see something is off. But there is also a chance it's just a bad shot. The CT will show us much more.

He will be staying at the hospital until tomorrow night, doctor will call me tomorrow with any updates.

It is SO nice to see clear, well done radiographs! (Especially without intestinal blockages or swallowed scary items! He look beautiful!)

These Vets seem like they know what they are doing. Please post name, address, etc. so we can add them to the list of trustworthy tortoise vets for others to know about.

You realize that "size" is the average, and that its very normal for each individual to have variants and differences from what is considered the "size it should be". As long as he's eating and active, consider his lungs normal for him. {If it ain't broke, don't fix it.}

And his head looks good in these.

Got results back yesterday evening. CT looks fine! Lung fields are fine, slightly smaller than average but nothing to worry about, no space occupying mass or fluid compressing the lungs.
They also got his head in the CT, and there is no boney involvement in the soft tissue swelling which is great news.
The CT also showed no signs of metastasis anywhere else if the biopsy comes back as cancer, so the doctor said if there is cancer surgery would be recommended and since there is no metastasis he'd be in good shape depending on what type it is.
But it still may be a benign mass, it may be a papiloma, it may also be an inflammatory process or hyperplasia we can treat with medication alone and he won't have to go through another surgery.
I also found one of my old notes showing his weight in November 2025 to be 790ish grams, today he weighed in at 780ish, so a slight loss, but he didn't eat this morning. At the ER in January he was something like 850, but when i told the doctor that was end of day after mazuri, greens, and a long soak, she said she is less concerned now.

I'll be picking him up tonight.

COmtnLady said:

It is SO nice to see clear, well done radiographs! (Especially without intestinal blockages or swallowed scary items! He look beautiful!)

These Vets seem like they know what they are doing. Please post name, address, etc. so we can add them to the list of trustworthy tortoise vets for others to know about.

You realize that "size" is the average, and that its very normal for each individual to have variants and differences from what is considered the "size it should be". As long as he's eating and active, consider his lungs normal for him. {If it ain't broke, don't fix it.}

And his head looks good in these.

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So if you look at those radiographs there is very little lung space pictured. Possibilities included free fluid or a space occupying mass pressing against the lungs.
On CT they looked relatively normal, so now the suspected causes of the original radiographs were they were poorly taken, excess food or gas in the GI tract, or he had some sort of infection that the antibiotic course he was on cleared.
So that was the concern. We probably would have just monitored if it weren't for the mass on his head.
I'll get biopsy results in 1-2 weeks.

Veterinary hospital is Stahl Exotic Animal Veterinary Services in Fairfax VA.
Very nice place. Made a very good first impression.

TY for the info on the place!


Torts are tough. He's fine, you'll see. (Its still good that you did all the tests and stuff though.)



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COmtnLady said:

TY for the info on the place!


Torts are tough. He's fine, you'll see. (Its still good that you did all the tests and stuff though.)



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Yeah, it's all just a precaution, and the CT also would have shown any malignancy, so if the mass is cancerous surgery may be a good option for him and potentially curative, depending on what type.
So overall so far it's good news. I'm not all that worried. I figure whatever it is I'll figure out a plan then. Just wanted to keep you guys and this thread updated.

Heres how it is looking. Except for where the vet cleaned it and biopsied, there's pretty much no change.
Hermann is well. Eating, super active, his usual grumpy self. I am soaking every day still. I give him a handful of food when in the bath so he gets some extra hydration Eating, but also to distract him so he doesn't get his head wet. He has a single suture to hold everything together where the punch biopsy was taken, but we aren't expecting it to heal since the tissue is unusual and unhealthy. It's just temporary to keep debris out until we know what the mass is and can develop a treatment plan.

But good thing is his CT was clean. So if it is cancerous, there is no metastasis yet. Hopefully surgery is curative.

When this is all over i think i will post another thread with photos and the timeline more clear, so others can learn from my mistakes. I shouldn't have taken short cuts and should have gone to a specialist first thing. I wish I'd done a biopsy back in January when this started.

Why didn't they take all the scar tissue off and send it to the lab instead of turning it into two or more procedures?

Its looking good other than that.

TY for the update. Its so nice to have a good outcome!!!

COmtnLady said:

Why didn't they take all the scar tissue off and send it to the lab instead of turning it into two or more procedures?

Its looking good other than that.

TY for the update. Its so nice to have a good outcome!!!

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Because we didn't know the margins yet, and we are hoping it is an inflammatory process we can hit with an NSAID so it will reduce without further operations.
Different masses are treated with different levels of aggression.
They don't think it is scar tissue, they think it is a mass.
It is still possible it is excessive granulation tissue like proud flesh, and that would be the ideal, but multiple doctors consulted and they agree it is appearing more like a mass. They don't think it was ever an abscess to begin with.
But we don't know. It's just an abundance of caution. We also didn't know at the time if his kidneys could handle anesthesia since his values were poor on previous blood work, but since we got repeat bloodwork that was clear we would be clear to go ahead in the future.

So Hermann had his surgery on Tuesday. Everything went well.
The original punch biopsy came back as a granuloma, suspected to have been cause by a bacterial or fungal infection, but there was no bacteria or fungus present in the biopsy so we sent the whole mass for pathology just in case. The doctor said it is possible that the original course of antibiotics knocked out the infection, and now we just need to deal with the mass itself. If the report comes back with an identified organism then we will treat accordingly to prevent any recurrence, but until then he isn't on any meds.

They removed it and stitched him up. He's been doing fine ever since, although I have not looked at him today yet.
I was instructed not to soak him until the recheck, but I think i probably will after a week or so just in very shallow water and with some food to distract him and keep him from acting crazy.
I'll update with his progress and with the pathologist report once I get it.
Because the mass was so large, they didn't have enough tissue to close on his head alone, so they pulled some of his neck forward.