Osteosarcoma, left scapular mass The examination is limited secondary to metallic susceptibility artifact by the presence of the left humerus endoprosthesis as well as by motion artifact. A large multifocal mass surrounds the scapula with replacement of the majority of the supra and infraspinatus muscles and a portion of the superior subscapularis muscle. Exact delineation of the mass is somewhat difficult given the multifocal nature however its entirety measures approximately 11 x 11 x 7.3 cm in the greatest craniocaudal, transverse, and AP dimensions. The mass demonstrates a multicystic appearance, appearing predominantly isointense to muscle on T1 sequences and hyperintense to muscle on T2 sequences. Areas of increased T1 signal within the supraspinatus and infraspinatus portions likely reflect areas of hemorrhage. Small scattered fluid fluid levels are identified within the mass and following contrast administration, there is a heterogeneous, septal-like enhancement pattern. Abnormal marrow signal is seen throughout the scapular spine. There is a mild amount increased signal and enhancement within the subcutaneous tissues likely reflecting edema and inflammation. There is partial visualization of scarring in the left upper lobe
Large multifocal mass surrounding the scapula consistent with recurrent malignancy.