Swelling over the shoulder

Chief Complaint A 47 y/o male presents with swelling over the shoulder. He noticed it 5-6 days back. History He has h/o HIV & squamous cell cancer of the tongue. Investigation CD4 count was 42/mm3 CD4 %age of 8.1% and a viral load of 49,400 copies/mL. Tuberculous test is negative, & chest X-ray was within normal limits. MRI attached below. Diagnosis Please give your views.

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Frozen shoulder / secondary of carcinoma tongue Physiotherapy and consulting to Oncologist and Orthopedic surgeon

Thanks Nihar Ranjan mohanty, Dr. Kute Ankush , Dr. Dinesh Gupta , Dr. Maqsud Ansari
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SUGGESTIVE. OF FROZEN SHOULDER DD METASTASES NEEDS FURTHER. EVALUATION

? SECONDARIES.. NEED'S.. HISTOPATHOLOGICAL STUDY..

Tnx Dr Vipin Bihari Jain
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Appears to be metastatic lesion..Bipisy of lesion and treatment accordingly...Also as CD 4 count is less pt will require prophylaxis for infection.

Its a geographic distribution of tumor Better to think of malignant Send only and only frozen section for biopsy to avoid metastasis

Known history of tongue cancer with hiv Sclerosis head of humerus Biopsy HP malignancy probably metastasis Pet scan

There is a lesson in humeral head Rule out tuberculosis CT guided biopsy

Frozen shoulder