Characterization of chest wall mass in right axilla Again seen is a mass in the right axilla abutting lateral aspects of several upper right ribs. The mass is approximately 11 x 3 cm in transverse dimension and approximately 10 to 11 cm in craniocaudal dimension. It is of predominantly fat signal intensity although contains a prominent lobulated nonadipose component laterally that is isointense to skeletal muscle on T1-weighted images, hyperintense on T2-weighted images, and enhances following gadolinium administration. A portion of this fatty mass posteriorly may be intramuscular within the serratus anterior. Intermediate signal intensity along the periphery of the mass may represent a capsule or perhaps splayed fibers of the serratus. The mass does not appear to invade the ribs.A second, smaller fatty mass is seen indenting the right teres minor/latissimus dorsi posteriorly. A third smaller fatty mass is noted with noted within the triceps musculature. A fourth fatty mass is noted within the upper paraspinal musculature to the left of midline.Osteoarthritis affects the right shoulder. Please note that this study is not protocoled for evaluation of the rotator cuff.
Multiple fatty masses as described above. The three smaller intramuscular masses are compatible with benign lipomas. The larger right axillary mass is also predominantly fatty and may represent a lipoma, but contains enhancing nonadipose elements as well. Overall, the mass appears similar to that seen on the cardiac MRI from September 28, and I suspect that the nonadipose elements within the axillary mass are benign; nevertheless, referral to an orthopedic oncologist is strongly recommended, as the possibility of a differentiated liposarcoma is also considered. If the patient has any prior cross-sectional imaging of this region (including CT scans) from outside institutions, then further comparison can be made.