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You should absolutely check with your primary care physician, because there is no way to be sure until you are checked. It could be what is commonly called a 'sebacious cyst', and if that's the case it will continue to grow and become tender or flat out painful until it drains or is removed. They are not cancerous and they are not threatening as a rule. They are filled with keratin (not sebum as is commonly believed), a white pus-like fluid that has a strong and revolting odor. They can be successfully removed if large and deep, but they often burst and drain on their own. They may be extremely tender and painful until they burst, at which time the pain instantly and completely dissipates.

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Q: What is an internal lump you can feel when you sit down sort of in bum lower back region?
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