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Images of Memorable Cases: Cases 135, 136, 137 & 138

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk. E-mail the authorsEdited By: Frederick Moody

http://rup.rice.edu/memcases-button.jpg

Cases_135_136_137_138-pres1-1.jpg 135

This 42-year-old woman had generalized lymphadenopathy, hepatosplenomegaly, and several hard, nonpainful, sternal masses.

Cases_135_136_137_138-pres1-2.jpg 136

This 60-year-old man had hematuria and a pulsatile sternal mass.

Cases_135_136_137_138-pres1-3.jpg 137

This 63-year-old man had a large, rounded, nontender, firm mass in the area of the right sternoclavicular joint. He was afebrile but had anemia, proteinuria, and renal insufficiency.

Cases_135_136_137_138-pres1-4.jpg 138

This 76-year-old woman presented with jaundice and a mass in the upper part of her sternum.

135. Hodgkin’s disease

Involving the sternum.

136. Renal cell carcinoma

Metastatic to the sternum.

137. Multiple myeloma

With plasmacytoma involving the right sternoclavicular joint.

138. Pancreatic carcinoma

Metastatic to the sternum.

Most sternal masses represent metastases. The primary tumor is usually lymphoma, multiple myeloma, or carcinoma of the breast, kidney, or thyroid. Pulsation of the mass strongly suggests multiple myeloma or metastases from renal or thyroid carcinoma.

Primary sternal tumors are almost always malignant and typically are chondrosarcomas.

In some cases, sternal swelling signals infection (e.g., tuberculosis, coccidioidomycosis, aspergillosis, brucellosis, and staphylococcal or pseudomonal disease).

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A lens is a custom view of the content in the repository. You can think of it as a fancy kind of list that will let you see content through the eyes of organizations and people you trust.

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Definition of a lens

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A lens is a custom view of the content in the repository. You can think of it as a fancy kind of list that will let you see content through the eyes of organizations and people you trust.

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