Malignant tumors of the shoulder girdle: Surgical and functional outcomes

Abstract

Background: Large resection and reconstruction of the malignant tumors of the shoulder girdle are used to provide maximum protection of the soft tissues with sufficient surgical margin. However, these have their own difficulties. The goals of this study were to review demographic data of 187 patients diagnosed with the malignant tumors located around shoulder between 2001 and 2016 in our clinic, to evaluate the functional outcomes and surgical outcomes, and to classify the resection methods according to new classification systems. Methods: There were 187 patients (108 male and 79 female) and the mean age at surgery was 47.9 (range 2-87). Fifty-one of these patients underwent biopsy only: 8 partial/total claviculectomy, 10 partial/total scapulectomy, 80 proximal humeral resection, 5 total humeral resection, 6 shoulder girdle resection, and 13 amputations. Eighty-six had prosthetic implants, five had fibula transpositions, and one had a massive homologous bone graft. Seventy-one of the 136 patients were followed for an average of 40.3 months. Results: When the bone resections were evaluated, the best results were obtained while the rotator cuff function is preserved in glenoid preserving partial scapulectomy, partial/total claviculectomy, and proximal humerus intercalary resection. In total, scapulectomy and proximal/total humeral resection operations' results were moderate because of partial or total injury of the abductor mechanism. Conclusions: As a result, malignant tumors of the shoulder girdle and soft tissue can be treated with limb-sparing surgery procedures. Reconstructive procedures and reconstructive methods such as prosthetic replacement, auto-allograft, and soft tissue reconstructions should be specified in each case. These resection and reconstruction methods are reliable and applicable procedures for local tumor control, pain control, and functional outcomes. More rarely, amputation/disarticulation can be performed.

Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection

“…The stage of the tumor as well as its volume and type of resection was shown to be correlated to patients’ survival in one study also showing high rate of complications for extra-articular tumor resections [ 11 ]. Even though endoprosthetic replacements seem to be a good option for patients requiring an intra-articular resection where the deltoid muscle and axillary nerve can be preserved, the results are not translatable to cases of more extensive extra-articular resections [ 16 , 29 ]. Furthermore, extra-articular resections were associated with high rates of local recurrences, a fact that possibly reflects the complexity of such tumor excision surgeries [ 30 ].…”

Management of chondrosarcomas localized to phanaxes

“…Chemotherapy is very ineffective, and radiation therapy is usually used only for palliation of patients with tumors that are not proper to surgical resection. Patients with metastatic chondrosarcoma, represent a difficult therapeutic challenge [13,14]. Recurrence rates of 22% to 62.5% have been reported in surgical treatment, especially only in curettage patients [7].…”

Cisto ósseo simples do acrômio: Relato de caso

“…As lesões benignas e malignas que podem acometer a escápula tendem a ser observadas na infância. 7,9 Indivíduos do sexo masculino são duas vezes mais afetados do que pacientes do sexo feminino. 1 Diferentemente de todos esses Fig.…”