Caceres’ Corner Case 105 (Update: Solution)

ESR_2012_Blog-CaceresCorner-590-CASE5105

Dear Friends,

Continuining with interesting cases seen in November, I am presenting the pre-operative chest radiographs of a 44-year-old man scheduled for hand surgery. Would you call the surgeon? What do you think the patient has?

Check the images below, leave your thoughts in the comments section and come back on Friday for the answer.


PA chest

lateral chest

Click here for the answer to case #105

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    Dec 2014
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    DISCUSSION 30 Comments

    30 Responses to : Caceres’ Corner Case 105 (Update: Solution)

    1. gus says:

      pseudotumor or pleural tumor in the right major fissure.

    2. Ferreiro says:

      Extrapleural lesion without evidence of aggressiveness.

    3. Jose Caceres says:

      Good, two answers and it’s only Monday!

    4. Ioana says:

      loculated pleural effusion in the right oblique scizure.

    5. Jane says:

      Maybe encapsulated fluid in the right major fissure.

    6. maka says:

      i think it is loculated pleural efusion…

    7. Jose Caceres says:

      Why an asymptomatic man would have fluid in the fissure? It usually happens in cardiac failure.

    8. manolis says:

      extra chest lesion

    9. aleksi says:

      empiema]

    10. Deepak Goyal says:

      Chest radiograph PA and Lateral views show a homogenous mass lesion having well defined medial, inferior, anterior and posterior margins. The lateral border of the mass is ill-defined. No rib erosion or calcification or pleural effusion is seen.
      I would like to see any previous films if available to see for interval change.
      It is a large lesion and the patient is asymptomatic — likely benign pleural mass.
      Pleural fibroma (solitary fibrous tumor of the pleura) or pleural lipoma are the possibilities. It can be a (? pedunculated) tumour attached to the lateral pleura or lie in the right oblique fissure.
      Is the hand surgery being done for pulmonary osteoarthropathy, ?
      since plural fibromas have an association with pulmonary osteoarthropathy.
      CT will resolve the issue.

    11. Genchi Bari Italia says:

      ….feliz Navidad,magico professore, da S.Domingo!!!! Sole, mare, rum , sigari ed amore…..ma non ti lascio neppure da Hispaniola ! Lesione pleurica , in asintomatica patologia cardiaca, può’. Essere solo il lipoma od un fibroma nodulare…….Arrivederci all’anno nuovo……..

    12. milos says:

      maybe tumor on scapula?

    13. marwin says:

      Tumor fibroso solitario

    14. Stelios says:

      Mesotelioma

    15. gus says:

      mary christmas!!!

    16. Stanko says:

      Most probably a benign tumor. If this was malignant, he would have symtomps, probably mets as well.
      There’s no effusion, no lymphadenopathy, no mediastinal shifting, no bone destruction etc.
      CT must be obtained for better evaulation of the lesion.
      Would I call the surgeon? Yes.
      Could he still perform the surgery? Probably.

      P.S.

      Merry Christmas!

      🙂

    17. pardeep bansal says:

      encysted pleural effusion in fissure

    18. m&m's says:

      LFTP or lipoma?

    19. PATO says:

      pleural tumor attached to major cisure, probably fibrous estirpe.

    20. DEEPAK GOYAL says:

      No answer on Friday ?
      Waiting for the answer.

    21. maciej says:

      LFTP ? lipoma?

    22. Miguel says:

      If it was a patient with a known cardiopathy I would say a Pleaural Effusion loculated in the major fissure. Since it is an asymptomatic patient I would say it is more likely to be a benign pleural tumor, probably lipoma.

      Happy Holidays

    23. inside beauty says:

      Extrapulmonary lesion, maybe a pleural solitary fibrous tumour.

    24. Dr. Mallikarjunappa says:

      Nice case

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