Lung cancer on shoulder film - FRCR viva film
GP referral of an elderly male with unremitting shoulder pain.
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Large mass centered on the right hilum, which is partially visualized on the film.
The shoulder is normal.
Classic FRCR viva or 2B rapid reporting film.
a. Pathology on the periphery of film.
b. Represetation of findings to query the candidates next management advice
Eg, I would report the film as an ALERT to the GP with advise for a chest x-ray to be performed and prompt referral to a respiratory physcian for further assessment.
c. In the case of a viva film, a CT may follow and further description required and staging of the tumor to be given.
Eg, CT shows a T4,N1,M1 (liver) lung cancer. Referral to Lung Cancer MDT indicated.