Gross Examination

The resected specimen was received in the gross pathology laboratory unfixed. It consisted of large, en-block resection containing portions of the right clavicle, ribs 1 -3, the manubrium, and associated skeletal muscle, soft tissue, and fat. The specimen measured 15.2 x 14.6 x 13 cm in overall dimensions (Image #4). The tumor mass was firm, rubbery multilobulated and tan – hemorrhagic on cut surface. The tumor demonstrated adherence to all three ribs, the manubrium, and the clavicle (Image #5). Gross invasion of the bone was not appreciated. The superior vena cava (Image #6) and a portion of the right subclavian vein were encompassed by the tumor; however gross invasion of these structures was not evident. Serial sections of the main tumor reveal an irregular cut surface ranging from firm, whorled, tan-white and fibrous to soft, dark gray and hemorrhagic.

Image 4	Image 5	Image 6
Anterior	Posterior with Rib	Superior Vena Cava surrounded by tumor