Shoulder pain in a 82 years old man with history of Stroke

Dear Ask The Doctor: This question pertains to my grandfather who is 82 years old and suffered a stroke over six years ago. He had been diagnosed with bursitis in his shoulder area, but recently had an x-ray revealing a large apical mass in the area. He is undergoing testing for the matter shortly. The question my family is wondering about is whether bursitis could be mistaken for an apical mass?

Dear Kieran: No, we are talking about two different things here; one is a problem in the shoulder, which is very common after suffering a Stroke: Hemiplegic Shoulder Pain, in the case he has movement limitation in that arm due to the Stroke, if this is not the case possibly may be a Bursitis. Regarding the apical mass, I assume that was seen in Chest x-rays, in the lung. It is not likely that the Shoulder pain was mistaken for an apical mass; in fact that finding in the chest x-ray gives a completely different set of symptoms and definitely has to be investigated comprehensively, moreover if your father is or was a smoker, has previous history of Tuberculosis contacts or he was exposed to asbestos.