DDX of chest wall masses

Approach to the DDX of chest wall masses:

  • Use ultrasound to try to determine organ of origin of mass from the outside in and whether it has a classic appearance
    • Skin – Pilomatricoma
    • Muscle – Infection / abscess, Hematoma
    • Bone / cartilage – Rib / cartilage anomaly
    • Blood vessels – Vascular malformation
    • Lymphatics – Lymphatic malformation, Lymph node
  • Otherwise the lesion is non-specific in appearance and a sarcoma cannot be ruled out
    • Consider MRI for further soft tissue definition