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An 80-year-old woman presented with pain at rest in the right shoulder. She noted swelling above the acromioclavicular (AC) joint increasing in size over the preceding 6 months. On examination, she was found to have a somewhat firm, non-tender, mobile mass of approximately 4 cm × 5 cm in size above the AC joint. The radiograph showed abnormal soft-tissue density superior to the AC joint. The differential diagnosis included geyser sign, sebaceous cyst, cutaneous neoplasm, subcutaneous lipoma, abscess and Virchow’s node. MRI revealed advanced degenerative change, complete rotator cuff …
Handling editor Josef S Smolen
Contributors SC: clinician, consenting of patient, writing up of case. GM: clinician, editing case write up, liaising with radiology for best images. PD: radiology images and description.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.