Presentation
Soft tissue mass in left biceps muscle.
Patient Data
Port-a-Cath in the right atrium, the subcutaneous port in the right chest wall.
Known soft tissue sarcoma in the upper half of the left biceps brachii muscle measuring 4.5 x 5.5 x 10.0 cm, tangential to the humerus, without bone erosion or appreciable periosteal reaction.
Bilateral lung metastases with irregular borders, the largest being in the RML-RUL and in the left lingula-LLL, encasing the hilar structures (but not narrowing them) and spreading along the interlobular fissure.
Metastasis to the pancreatic body, the lower pole of the right kidney and the left adrenal.
Small calcified plaque in right pleura at the level of the anterior arch of the 3rd rib.
Thin wedge-shaped subcapsular hypodense process in hepatic segment VI - perhaps a small infarction?
Chest X-ray was taken approximately 1.5 years after the CT shows that the lung masses have expanded.
Note a metal internal biliary stent.
Case Discussion
The patient had palpated a slowly-growing, non-tender swelling in her left arm. Ambulatory ultrasound and MRI demonstrated a nonspecific soft-tissue mass. Biopsy yielded high-grade sarcoma. She underwent PET-CT which showed the lung metastases. The follow-up CT presented here was done 10 months after initiation of chemoradiation therapy and 2 months after the previous CT. Unfortunately, despite therapy, none of the masses shrank. A chest X-ray taken 1.5 years later shows that the lung masses continued to grow.
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