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.
It occurs in 30% of males and 5% of females. It is more common in the young and becomes less visible with age.
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.
6 thoughts on “Dr. Pepe’s Diploma Casebook 154 – All you need to know to interpret a chest radiograph – Eighth Session – SOLVED”
good afternoon professor
Subcortical scalloping with periosteal new bone formation – osteomyelitis
However metastasis can be ruled out
METASTASIS CANNOT BE RULED OUT
Benign lesion as there is well defined sclerotic margin
Prominent Fossa rhomboidea, however the margins are somewhat more sclerotic than usual. Maybe in the OP for the port surgical resection a part of the clavicle because of TOS?
The contact point between the port and the catheter looks strange: cinical signs of disconnection?
benign bone lesion
Bone lytic lesion, ecxentric, wide transition zone. Agresive apperance, Metastasis may be the apropiate answer.