False-Positive Pregnancy Result in a Patient with Bone Mass.

Abstract

An 18-year-old woman presented to our institution complaining of a painful left shoulder. She described it as a sharp and throbbing pain that had begun insidiously but had progressively worsened to involve most of her left shoulder. She also noted that the pain would occasionally radiate down her arm and that she had difficulty mobilizing her shoulder, resulting in a pseudo-paralysis of the left upper extremity. She denied associated symptoms such as weight loss, anorexia, and fever. The remainder of her history was noncontributory. Except for the limited range of motion, her physical examination, including motor strength and sensation, was unremarkable. Radiologic imaging of her left shoulder demonstrated a large lytic bone lesion located on the proximal head of the left humerus with extension through the greater tuberosity to involve the deltoid muscle. A bone core needle biopsy demonstrated a mixture of mononucleated and multinucleated giant cells compatible with chondroblastoma, giant cell tumor, and Langerhans cell histiocytosis. As the mass had completely replaced the proximal head of the humerus, the patient underwent resection of the mass. During preoperative evaluation, her serum calcium was 8.4 mg/dL (reference interval, 8.6–10.6) and urine human chorionic gonadotropin (hCG)2 was positive (Combo Rapid Test B1077-23, Cardinal Health) with the confirmatory serum hCG of 38 IU/L …