This 80 year old, white male was referred to the surgical oncology clinic for evaluation of a right shoulder liposarcoma. The patient noticed the lump approximately three months ago and states the the mass continues to grow in size. An incisional biopsy was performed that revealed poorly differentiated liposarcoma. He is largely asymptomatic for this, but he does note a 15 pound weight loss over the past 6 months with decreased appetite. He denies any other significant disease.

His past medical history is non-contributory.

His past surgical history includes colon resection for diverticulitis in 1994, a gunshot wound in a hunting accident to his abdomen in 1980 and hernia repair in 1992.

A review of systems reveals a decrease in appetite over the past 6 months. All other systems are non-contributory.

He denies the use of alcohol. He has a smoking history, but denies the use of tobacco for the past 25 years.

Physical Exam:

On physical exam, we find a thin appearing male in no apparent distress. There is no cervical, supraclavicular or axillary lymphadenopathy. His lungs are clear to auscultation bilaterally. He has normal rate and rhythm without any murmurs, rubs, or gallop. His abdomen is soft, nontender and there are well healed surgical scars present. Examination of his right upper extremity reveals normal neuro function with motor and sensation intact. There is a 20 x 10 x 5 cm mass superficial to his right scapula which extending medially to the spinous process.The mass does not appear to impinge on the scapular function, and the scapula is not rasied off of the chest wall.

Admission Labs:

General Chemistry

Enzymes

Hematology

A CT scan of the chest was ordered to better delineate the relationship of the scapula and to look for lung metastases.