A 32-year-old male complains of a painful mass in the right anterior chest wall. He has noticed the mass for years, but it has become more painful. He has a history of multiple neurofibromas resected in the past. His father also had multiple tumors resected, but the pathology is unknown. He has smoked half a pack of cigarettes a day for the past 10 years. The mass is shown in Fig. 12.1 and is tender to the touch. He has a left Horner’s syndrome from previous resection of a neck mass. Neurological examination is otherwise normal. MRI of the neck is shown in Fig. 12.2.