Case of the Month

November 1998

This 29 year old man had complaints of pain and swelling in his left shoulder.  This had been present for nearly four years, and had gradually gotten worse over that time.  He worked as a cook, and had been essentially unable to use his arm for any work related activities for the past several months.  On physical examination his left shoulder was markedly swollen compared to the right.  Serpiginous, engorged superficial veins were prominent on the extremity.  He had a firm, rubbery mass that was palpable over the lateral aspect of his proximal humerus, and extended distally nearly to his elbow.   Several large, mobile axillary nodes were palpable.

Plain radiographs are shown below (1) (2).  Click on the images for a better view.

As part of his diagnostic work up, the patient had an MRI.  Selected frames are shown below; click on the images for a larger picture.

1) What is your diagnosis?  Click here for the answer
2) What treatment would you recommend? Click here for the treatment and results.