Image Quiz
Painless Shoulder Mass in a Fifty-Six-Year-Old Woman
Joseph J. King, MD, Christian M. Ogilvie, MD, Carol A. Dolinskas, MD, O. Hans Iwenofu, MD, John J. Brooks, MD, and Richard D. Lackman, MD
Department of Orthopaedic Surgery (J.J.K., C.M.O., and R.D.L.), Radiology (C.A.D.), and Pathology (O.H.I. and J.J.B.), Pennsylvania Hospital, Philadelphia, Pennsylvania 19104. E-mail address for R.D. Lackman: rilack{at}pahosp.com
A fifty-six-year-old woman presented with a ten-year history
of a soft-tissue mass in the left shoulder. The mass had increased in size over
the prior eighteen months. The mass was moderately painful with activities such
as heavy lifting or carrying. The patient had no night pain, nor did she have a
history of trauma to the area, erythema, bruising, fevers, chills, night
sweats, or weight loss.
Physical examination revealed a nontender subcutaneous soft-tissue
mass overlying the posterolateral deltoid muscle. There was no overlying warmth
or erythema. She had full active and passive range of motion of the left
shoulder and elbow. The neurovascular examination was normal, as were strength
and tone of the left arm. The remainder of the musculoskeletal examination was
normal.
On plain radiography, there was no evidence of osseous
involvement or soft-tissue calcifications. A computed tomography scan with
contrast was performed.
Fig. 1-A |
Fig. 1-B |
For larger view, click on image |
An open biopsy was performed, and a specimen was sent for
histologic analysis.
Fig. 2-A |
Fig. 2-B |
For larger view, click on image |
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