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

Shu-Wei Dee,¹ Mu-Jung Kao,^2,3 Chang-Zern Hong,⁴ Li-Wei Chou,^1,5 Henry L Lew<sup>6,7

1</sup>Department 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, USA

Abstract: 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