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Breast-Size Paired Bumps on the Back of an Old Man

Breast-Size Paired Bumps on the Back of an Old Man

This article was originally presented as an independent educational activity under the direction of CME LLC. The ability to receive CME credits has expired. The article is now presented here for your reference. CME LLC is no longer responsible for the presentation of the article.


HISTORY

Image 1A 93-year-old man with known Alzheimer dementia has his admission physical examination on transfer to a geropsychiatric hospital unit due to behavioral difficulties. A language barrier and his stoicism minimize communication, but his devoted wife translates and recounts that he is not in any physical discomfort. Has sometimes needed oxygen treatment in the past.

PHYSICAL EXAMINATION

Somewhat overweight man who appears a few years younger than stated age, affable but usually silent although he understands more English than he lets on. Breath sounds normal. Range of motion of upper limbs mildly reduced to a degree typical for age. Two hemispheric bumps on back feel utterly soft. Neither is fixed to overlying skin nor to chest wall. Small vertically aligned area of firmer tissue abuts medial margin of left-sided mass. No bruit audible over either. Bumps are distinct from scapulae, which move normally.

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