Abdominal palpation: Role play exam turned real

Today I had a somewhat rare and unpleasant (for both the patient and me as the examiner) findings during yet another lenghty palpation exam on Louisa's chubby stomach. Let's call her "Louisa" for anonymity reasons. It's the chubby stomach I devoted an Album to:

https://en.zity.biz/index.php?mx=gallery;ox=showalbum;ax=12393

However, normally enjoys Louisa having her stomach palpated by me very much. Today, her liver was tender during light palpation - which was surprising as a palpated her liver during light AND deep palpation just a week ago. When I deeply palpated her left upper quadrant, I felt a tiny knot in her tissue. It was probably either something in the deep layer of fat tissue or something in the rectus abdominis muscle, i assumed. However, I suggested to see a doctor and let him check her abdomen. This is something I only felt urged to during role play exams on two or three other occasions.

Does anybody has experienced a role play exam turns serious out of a sudden?

I had one play patient that I found a bump on his thigh. It was clearly on a muscle and had no visible surface problem. I told him he should have it checked, or at least monitor it. He asked for a follow up exam a week later and I found that it had gotten smaller. When he came back a month later it was undetectable.