Presentation
Enlarging and increasingly painful swelling in the right upper arm.
Patient Data
Ill-defined osteosclerotic lesion involving the cortex and medulla of the proximal humeral metaphysis and diaphysis with sunburst periosteal reaction and large necrotic soft-tissue mass.
Prominent vessels in the subcutaneous tissues of the involved segment.
No fracture. Normal shoulder joint.
Confluent necrotic right axillary lymph nodes partially encase the right axillary artery.
Right subclavian venous thrombosis with venous distension.
Multiple pulmonary metastases measuring up to 2 cms in diameter.
Otherwise normal.
The orange arrows indicates pulmonary metastases.
The green arrow demonstrates enlarged right-sided axillary lymph nodes.
The yellow arrow demonstrates right subclavian venous thrombosis.
Case Discussion
CT findings indicate an aggressive rapidly-growing osteoblastic tumor involving the right humerus and surrounding soft tissues with ipsilateral axillary lymphadenopathy, right subclavian vein thrombosis and pulmonary metastases. Histology confirmed osteosarcoma.
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