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Special Feature
February 2010

Image of the Month—Quiz Case

Author Affiliations

Author Affiliation: Department of Surgery, Easton Hospital, Drexel University School of Medicine, Easton, Pennsylvania.



Arch Surg. 2010;145(2):207. doi:10.1001/archsurg.2009.140-a

A 69-year-old woman who had had no primary care physician for more than 40 years presented with swelling in her right arm. She stated that she had been in reasonably good health and had only noticed swelling in the right arm approximately 2 weeks ago. The patient was found to have a widely neglected fungating chest wound (Figure 1 and Figure 2) with lymphedema in her right upper arm.

Figure 1
Breast image.

Breast image.

Figure 2
Computed tomographic scan of the chest.

Computed tomographic scan of the chest.

What Is the Diagnosis?

A. Shingles

B. Fungating malignant melanoma

C. Inflammatory breast carcinoma

D. Chest wall metastases from lung carcinoma