Case Report:
A 75-year-old male patient came to the outpatient surgery department at
Pravara Rural Hospital in Loni complaining of a 5-year-old swelling that
had been gradually getting worse over the left upper back and shoulder
region. History showed that the swelling was approximately 1 cm in size
when he first noticed it a few months ago but gradually grew in size
until it reached a large one. For six months, he also experienced
discharge from the swelling.
An extensive multi-lobulated soft cystic swelling measuring 20 cm by 17
cm by 10 cm was found during a clinical examination of the swelling over
the left upper back and shoulder (Figure 1). There was a cream-coloured
discharge that had the consistency of butter and was oozing from the
swollen punctum.
The patient’s ultrasound results showed a large, well-defined,
lobulated, heterogeneous hypoechoic lesion with numerous small
calcifications on the left upper back region (Figure 2). The Doppler
study revealed no internal vascularity or a solid component within the
swelling’s underlying aetiology. In the subcutaneous plane of the
cervical region and upper back region on the left side, there was a
multi-lobulated area of altered signal intensity that measured roughly
8.5 10.4 14.8 cm (AP TR CC), appeared hyperintense on T2W and STIR
images, and appeared hyperintense on T1W images. DWI showed diffusion
restrictions in these regions. Indistinct fat planes with the trapezius
are visible anteriorly. The trapezius was displaced laterally,
anteriorly, and posteriorly over the skin as a result of this lesion. A
thin peripheral enhancement was discovered during the post-contrast
study. Fat in the vicinity seems normal. Findings that could point to
sebaceous cysts.