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The large, infiltrative mass centred 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.