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JAMA Surgery Clinical Challenge
May 10, 2017

A Large Right Shoulder Mass

Author Affiliations
  • 1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
  • 2Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston
JAMA Surg. Published online May 10, 2017. doi:10.1001/jamasurg.2017.0853

A 43-year-old woman presented to the emergency department with substernal chest pain and dyspnea. After ruling out acute coronary syndrome or pulmonary embolus, a computed tomography scan of her thorax revealed lytic lesions of the sternum and second rib and a large mass involving the right scapula (Figure 1). On further inquiry, the patient acknowledged right shoulder pain that had been progressing over 5 months and leading to a limited mobility of the right upper extremity.

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