Localized shoulder pain.

Chief Complaint A 62 y/o female presents with the complaint of localized right shoulder pain. History Patient is diabetic. No other past medical history. Vitals BP: 130/80 mmhg, Resp: 17 bpm, Pulse: 76 bpm, Temp: 98.2 degree F Investigations X-ray shows an ill-defined radiolucency was noted within the scapula. MRI shows a 7 × 5 × 5 cm mass indicating a malignant soft-tissue mass. FNAC shows malignant cells in a trabecular pattern. All blood reports are normal. CT scan and ultrasound is also normal. CT thorax shows a 4 × 5× 3 cm solid mass in right lung with pleural adhesion. Diagnosis What is your opinion on the diagnosis? What next should be done?

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CA LUNG WITH SECONDARY IN SCAPULAR MUSCULATURE RX biopsy to confirm lung cancer Tapping of pleural effusion Chemoradiotherapy Sos surgical intervention

Thanx dr Kute Ankush
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Lung adenocarcinoma with metastasis Now a days immunotherapy based on nivolumab is highly effective, for metastatic lung cancer Few patients have survival as high as 5 - 10 years after diagnosis It is very costly, but future of cancer treatment is very bright, hopefully this treatment will become cheap as time progresses

? LUNG MALIGNANCY.. WITH.. ASSOCIATED.. SCAPULAR..SECONDARIES.. NEED'S.. HISTOPATHOLOGICAL EVALUATION..

Tnx Dr Vipin Bihari Jain sir
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Possibility of soft tissue sarcoma with lung metastases PET scan as next step Open biopsy may be needed for further planning

Mass requires excision and histopathology Further treatment on report with consultation of Oncologist

Thanks Dr. Kute Ankush
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Its Ca lung with mets. Resection of lesion followed by chemoradiotherapy as described by Dr. Shivraj

Elastofibromas