Chronic shoulder pain referred from thymic carcinoma: a case report and review of literature

Abstract

Shu-Wei Dee,1 Mu-Jung Kao,2,3 Chang-Zern Hong,4 Li-Wei Chou,1,5 Henry L Lew6,71Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, 2Department of Physical Medicine and Rehabilitation, Yangming Branch, Taipei City Hospital, Taipei, 3Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, 4Department of Physical Therapy, Hungkuang University, Taichung, 5School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 6Defense and Veterans Brain Injury Center, Virginia Commonwealth University, Richmond, Virginia, 7University of Hawaii at Manoa, John A Burns School of Medicine, Honolulu, Hawaii, USAAbstract: We report a case of thymic carcinoma presenting as unilateral shoulder pain for 13 months. Before an accurate diagnosis was made, the patient received conservative treatment, cervical discectomies, and myofascial trigger point injection, none of which relieved his pain. When thymic carcinoma was eventually diagnosed, he received total resection of the tumor and the shoulder pain subsided completely. Thymic carcinoma is a rare carcinoma, and our review of the literature did not show shoulder pain as its initial presentation except for one case report. The purpose of this report is to document our clinical experience so that other physiatrists can include thymic carcinoma in their differential diagnosis of shoulder pain.Keywords: referred pain, shoulder pain, thymic carcinoma