Presentation
Right deltoid region lump for the last few years. No pain.
Patient Data
A well-defined lesion (about 70 x 60 x 35 mm) between the humerus cortex and the deltoid muscle. Its upper end is at the humerus surgical neck level and its lower end is near the deltoid muscle insertion. Isoechoic to the adjacent subcutaneous fat. Hypoechoic to the adjacent muscle. Incomplete internal striations present without calcification/ cystic changes/ vascularity. Mild compressibility. The axillary nerve and accompanying artery are displaced and elevated by the lesion.
Intact rotator cuff.
Intraoperative photos show lipoma and retracted deltoid muscle. 2nd set of photos shows the specimen.
Case Discussion
A patient presented with a long history of deltoid region lump without local pain. Clinical examination suggested the possibility of the lesion being a lipoma. The ultrasound revealed subdeltoid lipoma without features suspicious for a liposarcoma. Surgical excision was done.
Intraoperative and specimen photos courtesy: operating surgeon Dr. Nisarg Patel.