History of recurrent osteosarcoma status post resection. Disease status evaluation pretreatment. Evaluation of the shoulder is markedly limited by metallic susceptibility artifact from the patient's humeral prosthesis. Since the prior study, the patient has undergone resection of the scapula and a large mass arising from the scapula representing metastatic osteosarcoma. There is edema of the surrounding soft tissues likely related to recent surgery. A collection of fluid signal intensity with peripheral rim enhancement extends posteriorly from the lateral margin of the second rib. I suspect this represents a seroma, but I cannot exclude the possibility of abscess development. This collection measures approximately 4.5 cm in AP dimension and approximately 1.5 cm in mediolateral dimension. It is approximately 3.5 cm in oblique craniocaudal dimension. Note is made of small axillary lymph nodes which appear to have fatty hila. Given the the aforementioned limitations of this study, I see no dominant nodular mass to indicate macroscopic residual tumor. Bandlike signal abnormality in the left upper lung likely represents chronic scarring.
Postoperative changes of scapular tumor resection as described above.