An adolescent with an axillary mass
Angela M Fagiana*, Daniel J Podberesky**, Kondi Wong***, Oluwole Fadare***, Christopher P Coppola****
Departments of Pediatrics*, Radiology**, Pathology***, and Surgery****, Wilford Hall Medical Center, San Antonio, TX
Abstract

A 13-year-old boy presented with a progressively enlarging right anterior axillary and chest wall mass. He first noted the mass three days after injuring his right shoulder while playing football. When the mass persisted, the possibility of hemorrhage into a soft tissue sarcoma in an adolescent was raised. Computed tomography and magnetic resonance imaging were used to evaluate the mass. Imaging revealed a multi-loculated cystic mass with an internal fluid-fluid level, and enhancement characteristics consistent with cystic lymphangioma and recent traumatic hemorrhage. This diagnosis was confirmed after histologic examination of the resected mass. This case illustrates an atypical adolescent presentation of cystic lymphangioma, manifest after trauma and masquerading as a soft tissue tumor. High resolution diagnostic imaging provided an accurate diagnosis and guided resection.
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