Case 22-1990 — A 19-Year-Old Woman with a Mass in the Shoulder, Jaundice, and Hepatosplenomegaly

Presentation of CaseA 19-year-old woman was admitted to the hospital because of a painful mass in the right shoulder and jaundice.The patient was well until approximately nine months earlier, when she began to have intermittent pain in the right shoulder. One month before admission the pain became more severe and at times radiated into the right upper arm; at about the same time she became aware of an enlarging mass in the right shoulder that was tender when she rolled onto it in bed. Her abdominal girth began to increase, and three weeks before admission anorexia and nausea . . .