Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive, deep-seated pain in the scapular region, worsening at night. Associated with localized swelling, palpable mass, and occasional systemic symptoms including low-grade fever and fatigue. No history of antecedent trauma. Symptoms are persistent and non-responsive to conservative analgesia.
Clinical Examination Findings
Inspection reveals visible asymmetry of the scapular region with overlying skin erythema or venous engorgement. Palpation identifies a firm, fixed, non-tender or mildly tender mass with ill-defined borders. Range of motion of the glenohumeral joint may be restricted due to pain or mass effect. Neurovascular status of the upper extremity is intact.
Treatment Protocol
Multidisciplinary approach initiated: Induction chemotherapy (e.g., VIDE/VDC-IE regimen) to achieve local control. Surgical planning for wide local excision or limb-salvage surgery of the scapula. Adjuvant radiotherapy indicated for positive margins or poor histological response. Close monitoring for systemic recurrence and long-term toxicity.