Case presentation A 69-year-old male presented with difficulty in raising his right arm and protruding shoulder blade. Examination revealed following Unusually prominent medial border and inferior angle of the right scapula (Image 1a) Retention of ability to shrug his shoulders Active abduction of the right shoulder: Limited to 130° (Image 1b) Active forward flexion to 110° History He was diagnosed with adenocarcinoma in the right upper lobe by fiber bronchoscopy. He had syphilis at age 20. He had undergone right upper lobectomy and lymph node dissection two months prior.
Video-assisted thoracic surgery (VATS) was performed; however, during the mediastinal lymph node dissection, the azygos arch was injured. Therefore, a thoracotomy was performed to stop the bleeding. The incision at the fourth intercostal space (ICS) made during VATS was extended. Next, the latissimus dorsi was…
