Reason: Evaluation of axilla/chest wall for possible recurrence of sarcoma after recent CT showed change in density of unclear significance. There are surgical changes of left apical lung and chest wall resection as described in prior CT scan reports. Foci of signal void within the adjacent soft tissues reflect metallic susceptibility artifact from surgery. There is enhancement along the apical pleural surface, including the region of concern on recent CT, likely representing scarring and sequela of prior radiation therapy, but we see no dominant nodular focus to confirm tumor recurrence. There is a small collection of rim enhancing fluid along the medial border of the scapula, which may represent seroma or mild bursitis, with mild edema and enhancement extending along an adjacent rib; this adjacent rib is of low signal intensity on all sequences, perhaps representing sclerosis from radiation therapy. Bone marrow signal intensity is otherwise unremarkable. There is mild edema within the deep fat adjacent to the subscapularis muscle, that may reflect prior therapy as well. There is a small glenohumeral joint effusion, which is incompletely imaged on this study.
Postsurgical changes related to left chest wall reconstruction as described above. We see no specific findings to suggest tumor recurrence. 