Soft-Tissue Mass. An Unusual Presentation of Metastatic Squamous Cell Lung Carcinoma

Abstract

A 61-year-old man, smoker, with no significant previous medical history, was admitted to the respiratory medicine department with a 4-month history of right suprascapular swelling, progressively increasing in size, accompanied by intense local pain and limited mobility of the right upper limb. He reported asthenia and weight loss during the previous 4 months. He had no anorexia, fever, or respiratory complaints. Physical examination revealed marked weight loss, a suprascapular right mass of about 10 cm, and decreased breath sounds were detected on lung auscultation. Blood analysis showed elevated systemic inflammatory markers. Chest X-ray (Fig. 1) revealed a dense soft tissue mass in the right scapula and a cavitating mass with an air-fluid level in the upper half of the left lung. Chest CT (Fig. 1) confirmed the presence of a bulky mass invading the right scapula and the adjacent muscles and a cavitating lung mass in the left upper lobe (see legend). Pathology examination of both lesions revealed a poorly differentiated squamous cell carcinoma of the lung with metastasis to contralateral soft tissues. During hospitalization, the patient’s general condition deteriorated progressively and, despite optimal supportive care, the patient died later due to disease progression.