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Desmoid Tumor of the Subscapularis Presenting as Isolated Loss of External Rotation of the ShoulderA Report Of Two Cases
Robby Singh Sikka, BS1; Milan Vora, BS; T. Bradley Edwards, MD1; Istvan Szabo, MD2; Gilles Walch, MD2
1 Fondren Orthopedic Group, 7401 South Main Street, Houston, TX 77030-4509. E-mail address for T.B. Edwards: bemd@fondren.com
2 Department of Orthopaedic Surgery, Clinique Sainte Anne Lumière, 85 Cours Albert Thomas, 69003 Lyon, France
The Journal of Bone & Joint Surgery.  2004; 86:159-164 
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Extract

Isolated loss of external rotation of the shoulder with the arm at the side is a rare clinical finding in patients presenting with a shoulder problem. Most patients with shoulder stiffness are first seen with a loss of mobility involving at least two planes of motion that usually results from primary or secondary adhesive capsulitis1,2. Soft-tissue tumors of the shoulder girdle are rare3. Among soft-tissue tumors, desmoid tumors are very rare and they most frequently occur in the shoulder girdle and the thigh of adolescents and young adults4. Desmoid tumors are slow-growing benign fibrous neoplasms arising from soft tissue and muscle. They have a notoriously high recurrence rate5,6. Adequate surgical resection can be challenging, and early diagnosis is intuitively beneficial in facilitating surgical management before the tumor has invaded and distorted the regional anatomy. We present the cases of two patients with a desmoid tumor originating in the subscapularis muscle who were first seen with vague progressive shoulder pain and a clinical examination pertinent for only marked limitation of active and passive external rotation of the shoulder with the arm at the side. The patients were informed that data concerning their cases would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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