PMC10328154_01
Plain radiography shows ascent of the humeral head, narrowing of the acromiohumeral
interval, glenohumeral osteoarthritis and inferior osteophyte, grade 2 of hamada rotator
cuff arthropathy.
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On a plain shoulder x-ray, we found ascent of the humeral head, narrowing of the acromiohumeral interval, glenohumeral osteoarthritis and inferior osteophyte, compatible with grade 2 of Hamada rotator cuff arthropathy (Figure 1).
(a) T1 sagittal image with presence of a well-delimited lesion in the teres minor.
Atrophy of the supraspinatus and infraspinatus. (b) T2 image of the lipoma in the teres
minor, humeral head ascent.
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As an incidental finding, a compatible image of the intramuscular mass compatible with fatty tissue in the belly of the teres minor (Figure 2).
Well-delimited lipomatous mass in the muscular belly of the teres minor, extracted by a
posterior approach of the right shoulder.
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Under general anesthesia, the patient underwent two procedures, the first one consisted in the excision of the tumor on the teres minor by a posterior approach of the shoulder parallel to the muscle fiber orientation, after the release of subcutaneous tissue, the teres minor muscle belly was identified and then the excision of the fat tissue tumor was done, after that an appropriate wound closure was performed through anatomical planes (Figure 3).
The cuts show mature adipose tissue consisting of adipocytes of regular size and shape
without evidence of stromal atypia. No other tissue component is identified.
Hematoxylin-eosin staining 40x.
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Clinical images of the patient 18 months after shoulder replacement and mass resection
with (a) forward elevation of 140 degrees, clinical pictures of the (b) 45 degrees of
external rotation (c) internal rotation at the level of T12 (d) posterior approach for
the excision of the lipoma and (e) anterior deltopectoral approach for the reverse
shoulder replacement were then obtained.
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The patient did not report pain and had good function that allows her to perform all daily activities with an elevation of 140  and without deterioration of external rotation (Figure 5).
Control x-ray of the shoulder's patient, 18 months after reverse shoulder replacement,
(a) on the anteroposterior view, (b) anteroposterior with abduction and (c) Y scapular
view.
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No local clinical tumor recurrence was noted (Figure 6).