Showing today the leading case of webinar eight. Radiographs belong to 27-year-old with seminoma and pain in the anterior chest wall. What is your opinion about the clavicular lesion?
3. Benign bone lesion
4. Any of the above
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Findings: the chest radiograph shows a lytic lesion in the proximal right clavicle (A-B, circles). It has a sclerotic border (A-B, red arrows), indicating a slow-growing process. This finding excludes options 1 and 2 and leaves option 3. Benign bone lesion as the correct diagnosis.
This lytic lesion correspond to a normal variant, called the rhomboid fossa. It represents the insertion site of the costoclavicular ligament( yellow), which extends from first rib (red) to the proximal clavicle (blue).
Is a normal variant and should not to be mistaken for an osteolytic lesion.
Final diagnosis: rhomboid fossa of right clavicle
Congratulations to Faelivrin, who made the correct diagnosis
Teaching point: it is important to know the most common normal variants of the chest, to avoid confusing them with pathology.