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Image challenge
Chest wall mass: what lies beneath?
  1. Claire Elaine Richards,
  2. Ahmed Mamdouh Taha Mostafa,
  3. Amr Elmoheen
  1. Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
  1. Correspondence to Dr Claire Elaine Richards, Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, 3050, Doha, Qatar; claireyr{at}hotmail.com

Abstract

Clinical introduction A 24-year-old Filipino man attended the ED with a 1-month history of a discrete swelling over his upper anterior chest wall that was rapidly increasing in size and tenderness. He denied any other symptoms. His medical history was unremarkable.

Examination revealed a tender, 7 cm × 6 cm mass over the upper part of the sternum (figure 1). The surface was smooth, it was immobile, non-compressible and the overlying skin was normothermic but mildly erythematous. Cervical lymphadenopathy was present. His vital signs were normal.

Figure 1
Figure 1

Chest wall mass.

Question What is the most likely diagnosis?

  1. Lipoma

  2. Chondrosarcoma

  3. Lymphoma

  4. Mycobacterium tuberculosis (TB)

Question

  • chest - non trauma
  • global health
  • imaging, ct/mri
  • infectious diseases, bacterial
  • musculo-skeletal, soft tissue infection

https://doi.org/10.1136/emermed-2018-207503

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    Footnotes

    • Contributors CER, AMTM and AE managed the patient at first presentation. CER wrote the manuscript, AMTM assisted with editing, and AE assisted with the literature search and edited the images.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Hamad Medical Corporation Medical Research Center.

    • Provenance and peer review Not commissioned; internally peer reviewed.