Reason: Malignant neoplasm of connective and other soft tissue of upper limb, including shoulder, right humerus lesion. History: Malignant neoplasm of connective and other soft tissue of upper limb, including shoulder, right humerus lesion. There is deformity and linear decreased signal abnormality within the subcutaneous tissue along the anterior and lateral aspect of the proximal and mid humeral diaphysis likely representing postsurgical scarring/postsurgical change. Note is made of multiple foci of increased signal abnormality on fluid sensitive sequences within the cortex along the anterior aspect of the mid diaphysis of the humerus which demonstrate minimal enhancement on postcontrast sequences. While these findings may represent a combination of postsurgical change/granulation tissue and post radiation therapy change, the possibility of residual or recurrent tumor cannot be completely excluded. There is additional enhancement within the subcutaneous tissues of the surgical bed which may also represent postsurgical change/granulation tissue versus small foci of residual disease. There are multiple foci of signal void in the surrounding area presumably representing postsurgical change. No additional bone marrow signal abnormality is identified. There is a small amount of fluid within the glenohumeral joint. Although this examination was not protocoled for detailed evaluation of the rotator cuff, there is a high riding humeral head and apparent complete tear of the supraspinatus with retraction to the level of the glenohumeral joint. There is also nonspecific increased signal abnormality within the deltoid and teres minor on fluid sensitive sequences which could represent subacute denervation.
Multiple foci of enhancing signal abnormality within the subcutaneous tissue along the anterior aspect of the mid diaphysis of the humerus, as well as within the anterior cortex of the humerus, may represent a combination of postsurgical change/granulation tissue and post radiation therapy change, however, the possibility that these findings represent small foci of residual or recurrent tumor cannot be excluded.