Funny, I just worked on a tree which had this growing on a limb. It was a weeping birch, not a river birch like yours looks to be. I was instructed to remove the limb, because my employer thought it was a gall. After I removed the limb, I ripped the suspected piece of wood. Good sound wood throughout the whole thing, the attachment to the parent stem seemed to be intact and functional...as in the growth was not adversely affecting the vascular system of the branch. So, I believe what I cut was a small burl, just as this is. I agree with Starlet.