Neoplastic brachial plexopathy

Case contributed by Dr Dalia Ibrahim

Presentation

History of left breast cancer. The patient had left mastectomy and ended chemoradiotheraputic treatment. The patient currently developed "left Horner's syndrome"

Patient Data

Age: 47
Gender: Female
Modality: MRI

An irregular shaped spiculated soft tissue mass lesion is seen at the left supraclavicular region invading the left brachial plexus, it elicits low signal at T1 and high signal at T2 & STIR WI showing mild post contrast enhancement. likely representing metastatic mass. 

Diffuse soft tissue edema within the deep fat planes of the left side of the neck, left supraclavicular and left axillary regions likely post theraputic (radiation) changes.

Multiple enlarged bilateral deep cervical, right supraclavicular ,right axillary and superior mediastinal lymph nodes, likely metastatic nodes.

 

Annotated images

Modality: Annotated image

"Red arrows" An irregular shaped spiculated soft tissue mass lesion is seen at the left supraclavicular region invading the left brachial plexus, it elicits low signal at T1 and high signal at T2 & STIR WI showing mild post contrast enhancement. likely representing metastatic mass. 

"Orange arrows" Multiple enlarged bilateral deep cervical, right supraclavicular ,right axillary and superior mediastinal lymph nodes, likely metastatic nodes. 

 

Case Discussion

Horner's syndrome is acquired as a result of a disease but may also be congenital or iatrogenic, although most causes are relatively benign, Horner syndrome may reflect serious diseases in the neck or the chest (Neoplasms) such as "Pancoast tumor" or "metastasis from breast cancer" which are the most common causes of neoplastic brachial plexus invasion.

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Case Information

rID: 27819
Case created: 21st Feb 2014
Last edited: 6th Nov 2015
Inclusion in quiz mode: Included

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