EURORAD ESR

Case 14993

An unusual shoulder lump

Author(s)
Nichelli L., Ciliberti M., Torricelli P.

Azienda Ospedaliero-Universitaria di Modena - Policlinico, Dipartimento di Diagnostica per Immagini; Largo del Pozzo, 71, 41125, Modena (MO), Italy.

Email:lucianichelli@gmail.com
 
Patient
male, 58 year(s)
 
 
  • Figure 1
    Shoulder sof tissue thickening
     

    Shoulder X-ray showing visibile soft tissue thickening.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Plain radiographic studies; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Comparison with the first radiography.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Plain radiographic studies; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Comparison of the two radiographs with measurements.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Plain radiographic studies; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 2
    MR without contrast administration
     

    Axial T2-weighted image.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T2-weighted image showing a large, mass-forming tissue, with indistinct boundaries. Central area of colliquative necrosis is also visible.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T2-weighted image demonstrating epimysium invasion and reticulation of the subcutaneous fat.

     
    Area of Interest: Haematologic; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal T1-weighted image highlighting swollen musculature.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal T1-weighted image showing multiple enlarged axillary lymph nodes.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal T2-weighted image.

     
    Area of Interest: Haematologic; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal SPAIR, illustrating a heterogeneously hyperintense muscle enlargement.

     
    Area of Interest: Haematologic; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    MR with contrast administration
     

    Axial T1 with gadolinium.

     
    Area of Interest: Haematologic; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Sagittal T1 with gadolinium.

     
    Area of Interest: Haematologic; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Ultrasound before percutaneous biopsy
     

    Shoulder musculature is markedly swollen and completely replaced by an heterogeneous tissue.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Ultrasound; Procedure: Biopsy; Special Focus: Neoplasia;

    Shoulder musculature is markedly swollen and completely replaced by an heterogeneous tissue.

     
    Area of Interest: Haematologic; Imaging Technique: Ultrasound; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
Shoulder X-ray showing visibile soft tissue thickening.
 
Comparison with the first radiography.
 
Comparison of the two radiographs with measurements.
 
Axial T2-weighted image.
 
Axial T2-weighted image showing a large, mass-forming tissue, with indistinct boundaries. Central area of colliquative necrosis is also visible.
 
Axial T2-weighted image demonstrating epimysium invasion and reticulation of the subcutaneous fat.
 
Sagittal T1-weighted image highlighting swollen musculature.
 
Sagittal T1-weighted image showing multiple enlarged axillary lymph nodes.
 
Sagittal T2-weighted image.
 
Sagittal SPAIR, illustrating a heterogeneously hyperintense muscle enlargement.
 
Axial T1 with gadolinium.
 
Sagittal T1 with gadolinium.
 
Shoulder musculature is markedly swollen and completely replaced by an heterogeneous tissue.
 
Shoulder musculature is markedly swollen and completely replaced by an heterogeneous tissue.
 
 
 
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