Introduction
In the first place, one of the causes of shoulder pain can be a malignant tumor or a benign tumor that is growing in the shoulder blade or the humerus bone. With this in mind, this can lead to a humerus fracture, which physicians consider a pathological fracture. In contrast, they distinguish this from a fracture, which is the consequence of trauma. Certainly, benign bone cysts are not uncommon. Benign myxomas can also be found in the shoulder area.
Unfortunately, on the other hand, malignant tumors are also not uncommon. Indeed, osteosarcoma is one of the common malignant tumors. It often presents in a child or teenager. Clinically this type of tumor likes to grow in the arm or in the lower extremity. A malignant fibrous histiocytoma that originated in the shoulder blade (=scapula) is shown here.
Cancer from other areas can metastasize into shoulder
For one thing, other cancers can metastasize into the shoulder such as kidney cancer, breast cancer as well as prostate cancer. It seems like not infrequently they tend to metastasize into the humerus bone and the shoulder blade. About 18% of breast cancer patients develop humerus metastases (Ref. 5). Here is an example of a liver cancer having metastasized into the shoulder. Non-Hodgkins lymphoma can also metastasize into the humerus.
Usually there is pain in a shoulder with a metastasis or a primary bone tumor in the humerus or scapula. X-rays, CT, MRI scans, or bone scans might suggest a tumor. However, only tissue diagnosis such as a bone biopsy under CT guidance with histopathological analysis of the material will confirm the diagnosis. An orthopedic surgeon and likely an oncologist need to be consulted to help with the proper work-up and the appropriate treatment protocol including possible bone surgery.
References
1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.
2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.
3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
4. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
5. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
6. Wheeless’ Textbook of Orthopaedics: http://www.wheelessonline.com/ Several topics can be found under this link by entering the term you search for.
7. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
