sb/hs/rg/nl
Date : 00.00.0000

Name of the Patient : Abc Xyzikesh Plmn / M / 10 yrs.
Referred by : Dr. Abc Xyz
Examination : M.R.I. of the Left Shoulder.

CLINICAL PROFILE :

C/O progressive swelling in the region of the left shoulder since 6 months. Operated for the same on 00.00.00.
HP s/o ? Rhabdomyosarcoma ? Ewings sarcoma.
No complaints at present.

EXAMINATION :

M.R.I of the left shoulder was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

5 mm thick T1 Weighted and GRASS sagittal images.

4 mm thick T1 Weighted, Proton and T2 Weighted coronal images.

OBSERVATION :

There is evidence of a well-marginated, lobulated approximately 4.5 x 3.0 x 2.8 cms sized intermediate signal intensity mass lesion on the T1 Weighted images in the left clavicular fossa, between the supraspinatus muscle and the trapezius muscle. This lesion appears hyperintense on the T2 Weighted images. The fat plane between the inferior margin of the mass lesion and the supraspinatus muscle is well-identified whereas the fat plane between the superior margin of the mass lesion and the trapezius is slightly ill-defined, probably due to previous surgery. The scar of previous surgery with susceptibility artifacts is noted in the supraclavicular region laterally. The trapezius muscle is stretched over the superior margin of the lesion whereas the supraspinatus muscle is displaced slightly inferiorly by the

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lesion. Focal signal-void areas within the lesion may represent calcific densities/fibrous strands/blood vessels. There is no extension of the lesion into the shoulder joint per se. The gleno-humeral joint, the epiphysis of the humeral head and the proximal shaft of the left humerus are unremarkable.

The acromio-clavicular joint is also unremarkable. No obvious bony involvement is noted. The subcutaneous tissues around the mass lesion appear hyperintense on the T2 Weighted and GRASS images, most likely due to previous surgery. The visualized left axilla is unremarkable.

IMPRESSION :

The MRI features suggest an approximately 4.5 x 3.0 x 2.8 cms sized mass lesion in the left clavicular fossa, between the supraspinatus muscle and the trapezius muscle with signal characteristics and extensions as described. The histopathology was suggestive of ? Rhabdomyosarcoma, ? Ewings sarcoma.

No previous investigations were available for comparison.