Neoplastic vs. radiation brachial plexopathy
My husband was diagosed with left upper lobe lung cancer and was subsequently found to have a 5 cm mass in the right shoulder. He was having weakness, paresthesias and extreme pain in the shoulder down to the elbow, top of hand and 3, 4 and 5 fingers on the right hand. He underwent lobectomy prior to finding the mass in the shoulder and then underwent radiation to the shoulder and chemotherapy. The pain almost completely subsided, but slowly started returning about 3 months after the end of his radiation and chemo. Now it is back to being extreme. We had an MRI of the shoulder when he was first diagnosed with lung cancer at one institution that was negative and after the lobectomy we went to another institution and had another MRI that showed the 5 cm mass. Are there different MRI techniques where one would pick this up and the other would not? My husband is currently having to take 120 mg OxyContin b.i.d. with OxyIR 10 mg every 4 hours. The pain is exactly the same as it was before the radiation. Could this be radiation fibrosis or are we dealing with metastasis again? Any information would be helpful. Thanking you in advance.
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