Presentation
35 years old male with history of sarcoma. Weakness in distal right upper limb.
Patient Data
The large, infiltrative mass centered in the right supraclavicular region remains evident. There is destruction of the adjacent first rib and infiltration of the trunks and divisions of the brachial plexus. The right subclavian vessels are partially encased. The mass abuts the undersurface of the right clavicle and extends into the apex of the right lung and abuts the upper 2 thoracic vertebrae. A separate nodule deep to subscapularis causes cortical destruction of the adjacent scapula.
Case Discussion
Malignant soft tissue tumors such as sarcomas may be difficult to differentiate on MRI. Any primary tumor in the vicinity of the brachial plexus may displace, compress or infiltrate the brachail plexus to cause corresponding clinical symptoms. Other evidence of neoplastic disease affecting the brachial plexus includes lymphadenopathy, bony lesions, intrathoracic and chest wall masses 1,2.
Case courtesy of A/Prof Pramit Phal.
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