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Hard lump at occiput. Occasional pain and tenderness.
Wedge-shaped bony projection arising from external occipital protuberance.
Although occipital spurs are somewhat common in males, a painful / tender / painless hard lump should not be ignored until it is proven to be benign. This is because such a lump may also be due to a primary or secondary malignancy involving the cranium.
As regards the occipital spur, x-ray is conclusive and no further evaluation is required.
Surgery is curative, but may be delayed / avoided if the patient can sustain with using soft pillows, analgesics etc.