Clinical Images
Fungating Chest Wall Mass
A 71-year-old Caucasian male writer with no significant past medical history presented to the Emergency Department with fatigue and a large chest wall mass for which he had not sought prior medical care. His weakness and fatigue had progressively worsened over the last several months. He denied any recent travel outside the San Diego area where he lives. He denied any history of drug or alcohol use. He had no known family history of cancer.
On physical exam, we noted a large and protruding fungating chest wall mass. The mass was weeping thick yellowish fluid that measured 25cm x 15cm and extended from the lateral edge of the axilla to the mid-sternum. The patient had normal sensation over the mass, and experienced no pain on its palpation. He had no restriction of movement, his heart had a regular rate and rhythm, his lungs were clear to auscultation bilaterally, he had no midline spinal tenderness, and he was alert, oriented and in no acute distress.
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AUTHORS:
Aadel A. Chaudhuri, MD PhD
Kelsey U. Ryan, MD
Steve T. Popper, MD
Lauren H. Clarine, DO
Levanto G. Schachter, DO
AUTHOR BIOS: Aadel A. Chaudhuri is doing his medical internship at Scripps Mercy Hospital in San Diego, after which he will be a resident in Radiation Oncology at the Stanford University Medical Center. Kelsey U. Ryan is a resident in Family Practice at Scripps Mercy Hospital in Chula Vista. Steve T. Popper is a resident in Internal Medicine at Scripps Mercy Hospital in San Diego. Levanto G. Schachter is a Chief Medical Resident in Internal Medicine at Scripps Mercy Hospital in San Diego, and recently accepted a position at Scripps Green Hospital as a Hematology/Oncology fellow.