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This is an example of a patient

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that has recurrent tumor involving

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the left brachial plexus.

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So, this was a patient that had left

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sided breast carcinoma that was

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treated with radiation chemotherapy.

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So, when we look at the bottom right image,

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we actually see evidence of a metastatic lymph

0:17

node involved in the left axillary region.

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So, we know in this case

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there is recurrent tumor.

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When we look at the bottom right image on

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the coronal non-contrast T1-weighted image,

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we can see the subclavian artery here and we

0:29

can see all of this diffuse enhancement and

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thickening involving the left brachial plexus.

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So, when we go back to the right image,

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we can see that all of that soft tissue

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is diffusely enhancing and thickening.

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And it's extending more centrally along

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the expected course of the brachial plexus.

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We can also see a focal mass involved in the

0:48

inferior portion of the subclavian artery,

0:51

which is extending into the chest wall.

0:54

Again, these are all findings consistent

0:56

with recurrent breast carcinoma

0:58

extending along the brachial plexus.

1:00

When we look at the top left image, again,

1:03

how do we find that brachial plexus?

1:05

Well, what I do is I look for the

1:06

subclavian artery, and as I follow the

1:08

subclavian artery laterally, there's

1:11

that subclavian artery, so I know the

1:13

brachial plexus is directly adjacent to it.

1:16

So, we can see that the subclavian artery is

1:18

completely encased by this recurrent tumor.

1:22

And on the right-hand side, when we look at

1:25

the post-contrast T1-weighted image, we can

1:27

see all of that soft tissue is enhancing.

1:30

It's encasing the carotid artery, and we

1:33

can also see a focal soft tissue mass

1:36

extending into the apex of the left lung.

1:39

So, in this particular case, we have an

1:41

example of recurrent metastatic breast

1:44

carcinoma with a metastatic lymph node.

1:47

We can see this diffuse abnormal tumor extending

1:50

along the brachial plexus, and we can also

1:52

see the tumor involving the left chest wall.

1:56

So, unfortunately, this is a fairly

1:58

classical example of recurrent

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tumor involving the brachial plexus.