Cáceres’ Corner Case 218 – SOLVED

Dear Friends,

an easy case to celebrate the new year. PA radiograph of a 36-year-old woman with chest pain.

What do you see?

Click here to see the answer

Findings: PA chest radiograph shows a fracture of the right clavicle (A, arrow). A magnified view of the area raises the possibility of a lytic lesion (B, arrow).

Specific low-Kv images of the clavicle were taken, showing a rounded permeative lesion with a pathological fracture (C, arrow. D, circle). No other lesions were demonstrated in a bone scan. Biopsy followed by surgery came back as chondrosarcoma.

Final diagnosis: chondrosarcoma of clavicle with pathological fracture
 
Congratulations to Archanareddyt, who discovered the pathological fracture
 
Teaching point: when evaluating bone lesions of the chest, take specific views. They allow a better interpretation of the pathologic changes

12 thoughts on “Cáceres’ Corner Case 218 – SOLVED

    1. Pain was located in the right clavicle. No clinical suspicion of pulmonary embolism. The mild prominence of the pulmonary segment may be due the slight scoliosis which may alter the mediastinal contour.

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  1. Good afternoon Professor

    Happy New Year 2020

    Chest PA view:
    1. Old mildly displaced fracture of the right lateral third of clavicle with ongoing callus formation.
    2. Prominent pulmonary bay.
    3. Right heart border – not clearly visualized – Suggested lateral view to rule out Pectus excavatum.

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