Lump On Shoulder Blade. Done Biopsy. What Could Be This Lump?

Posted on Wed, 3 Oct 2012

Question: My husband had a grape-sized lump on his shoulder blade. The doctor said it was likely a cyst but that it should be removed. When they removed it, they did a biopsy. We hadn't heard back about the results, so we called today and they said they weren't sure what it was and had to send it to the Mayo Clinic. What could it be?

Answered by Dr. Anil Grover (2 hours later)

Hi XXXXXXX,
Thanks for writing in.
I read your email with diligence.

Let me reassure you the fact they have sent it Mayo Clinic is not because of Mayo Clinic's proximity to your city of St XXXXXXX It is because of superior diagnostic facilities and I may conclude your doctors think it is benign. As logistics of sending a sample for review is the same if they were suspecting malignancy a) they would have told you about the suspicion and b) After that it is guessing game what it turns out to be:
a) Hydatid Cyst: very rare in US but definitely seen.
b) Benign embyonic cell tumor rare but possible

other causes of cysts like Sebaceous cyst, synovial cyst would have been diagnosed at your hospital.

I know suspense of waiting is at times irritating but correct diagnosis on which treatment depends is more important.

If you have any follow up query, I will be most happy to answer it. Keep me posted please.

With Best Wishes.

Dr Anil Grover MBBS, MD(Internal Medicine), DM (Cardiology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anil Grover (3 days later)

The actual diagnosis is myofibroblastic sarcoma.
The biopsy was sent to Mayo because there is one physician there who specializes diagnosing this.

Answered by Dr. Anil Grover (26 minutes later)

Hi XXXXXXX,

Thanks for informing.

Well, if there is a person in Mayo Clinic, which I guess is about one and half hour drive from St XXXXXXX please set up an appointment and XXXXXXX the specialist. Whatever little I know about this disease is:

a. Prognosis depends upon degree of malignancy or differentiation of cells, it is a range from low grade to high grade and obviously low grade malignancy responds better. Operative word is RESPOND
b. Usually, treatment of such tumors is team approach, combination of radiotherapy, surgery and chemotherapy: patient needs all. Cure is a possibility.

I know it is difficult moment for you, I empathize with you and wish you all the best: wishes that are sincere and heartfelt.

Good Luck.

Dr Anil Grover

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Above answer was peer-reviewed by : Dr. Shanthi.E