Metastatic renal cell cancer There is a destructive lesion within the scapular neck measuring approximately 3 x 2 cm in the transverse dimensions and approximately 3 cm in the craniocaudal dimension. There is irregularity of the adjacent cortex anteriorly representing tumor penetration. Edema type signal is noted within the adjacent rotator cuff musculature, particularly within the subscapularis, but there is no definite adjacent soft tissue mass. The scapular lesion does not appear to extend into the suprascapular notch.ROTATOR CUFF: There is a small focus of increased signal intensity within the distal supraspinatus tendons anteriorly representing a partial-thickness, likely concealed interstitial tear with a small cyst in the underlying greater tuberosity. The infraspinatus and teres minor tendons appear intact. Evaluation of the subscapularis is limited by rotation of the humeral head however there is linear fluid signal intensity traversing the tendon distally suggesting focal full-thickness tearing which is of uncertain clinical significance.SUPRASPINATUS OUTLET: There is moderate osteoarthritis of the acromioclavicular joint. A trace amount of fluid is noted within the subacromial subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: There is mild osteoarthritis of the glenohumeral joint. A small amount of fluid is present within the subscapular recess and glenohumeral joint but there is no sizable joint effusion. The anterior labrum appears slightly attenuated which may reflect chronic attritional tearing.BICEPS TENDON: There is mild increased signal intensity of the tendon of the long head of the biceps suggesting mild tendinosis.
1. Lesion of the glenoid of the scapula representing metastatic disease.2. Focal full-thickness tearing of the subscapularis tendon and partial thickness insertional tearing of the supraspinatus tendon.3. Edema within the rotator cuff musculature, particularly of the subscapularis, which may in part be secondary to radiation therapy given the patient's history.4. Osteoarthritis of the glenohumeral and acromioclavicular joints with other findings described above.