We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
An Unusual Case Of Left Shoulder Mass.
- Authors
Mittal, Ram Niwas
- Abstract
Introduction Muscle masses can be of different forms and differential diagnosis is wide ranging. The most common tumors are lipomas, cysts, haemangiomas, liposarcomas, myxomas, desmoid, rhabdomyosarcoma and metastasis. Among these, lipomas are the most frequently occurring soft tissue neoplasms. Primary hydatidosis of muscle is a very rare entity and that presenting in deltoid is even rarer. Presence of rice bodies in such parasitic mass is even rarer. Multiple radiological modalities are needed to differentiate benign mass like that of parasitic origin from a malignant one and involvement of onco-radiologist is important in such cases. Case 40-year-old, male presented with a painless swelling in the region of left shoulder and upper arm for the last 2 years. The swelling was gradually increasing in size. On examination, there was a diffuse, soft swellingover anterolateral aspect of left shoulder and upper arm. There was no sensory or motor deficit. On workup, ultrasound revealed a large, lobulated, hypoechoic, lesion, in the anteromedial & anterolateral region of left shoulder. MRI also revealed similar findings with signal intensity component involving deltoid muscle. On FNAC, thin yellowish fluid was aspirated and diagnosed as benign cystic lesion. On exploration, it was found to be a thick walled cystic lesion, encircling the lateral, anterior and medial aspect of upper humerus. Lesion was completely excised. In the process of excision, the lesion got ruptured at one sitefrom where multiple, small whitish soft nodules popped out. Post-operative period was uneventful. Final histopathology report came as parasitic cyst. Conclusion A hydatid cyst is a parasitosis formed mainly due to E.granulosis. Intramuscular primary hydatidosis is very rare as larvae are not able to survive in muscle due to muscular contraction thereby leading to lactic acidosis. Our case is unique, interesting and rare because of rice body formation secondary to parasitic tumor of deltoid muscle. Although MRI is quite specific but in our case, none of the imaging modalities could detect and define rice bodies andnature of the mass. This case highlights the diagnostic dilemmas faced and highlights the importance of operating surgeon, onco-radiologist, team work and patient specific diagnosis. Details of first author Dr Ram Niwas Mittal M.S (General Surgery), Fellowship (Pursuing) in Head and Neck Oncology (IFHNOS) Senior Consultant,
- Subjects
LIPOMA; LIPOSARCOMA; SOFT tissue tumors; DELTOID muscles; SHOULDER; DIFFERENTIAL forms; MUSCLE tumors
- Publication
Journal of Cancer Research & Therapeutics, 2017, Vol 13, pS330
- ISSN
0973-1482
- Publication type
Article