RT Journal A1 Markelov A, Kohli H T1 IMage of the month—quiz case JF Archives of Surgery JO Archives of Surgery YR 2010 FD February 1 VO 145 IS 2 SP 207 OP 207 DO 10.1001/archsurg.2009.140-a UL http://dx.doi.org/10.1001/archsurg.2009.140-a AB A 69-year-old woman who had had no primary care physician for more than 40 years presented with swelling in her right arm. She stated that she had been in reasonably good health and had only noticed swelling in the right arm approximately 2 weeks ago. The patient was found to have a widely neglected fungating chest wound (Figure 1 and Figure 2) with lymphedema in her right upper arm.