Total scapulectomy for metastatic pheochromocytoma of the scapula case report

Momose, T; Nakatsuchi, Yukio; Saitoh, S.

doi:10.1007/bf00381067

Cited by 3 publications

(2 citation statements)

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“…Eine Indikation besteht aber auch bei Sarkomen der Weichteile, wenn diese in enger anatomischer Beziehung zur Skapula lokalisiert sind [2][3][7][8][9]. Auch Knochenmetastasen anderer Tumoren k6nnen in seltenen F/illen eine Skapulektomie erforderlich machen [5,7]. Die Art der Resektion (total/subtotal/partiell) hfingt allein von der Lokalisation und Ausdehnung des Tumors ab.…”

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“…Unsere Patienten haben aber gezeigt, dab der Arm nach intensivem krankengymnastischem Training im t/iglichen Leben sehr gut einsetzbar ist. Dies wird in den wenigen Mitteilungen fiber totale Skapulektomie best/itigt [5][6][7]9]. So konnte ein aus onkologischer Sicht wesentlich verl/iBlicheres operatives Ergebnis erreicht werden als mit einer reinen Resektion von Weichteilen, und dabei wurde eine brauchbare Extremit/it erhalten.…”

Section: Diskussionunclassified

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Die skapulektomie als extremit�tenerhaltender eingriff in der chirurgie der weichteilsarkome

Zornig

Busch

Nicolas

1992

Langenbecks Arch Chir

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In the treatment of soft tissue sarcomas, radical surgery may mean total scapulectomy. If the tumour is localized next to the scapula wide margins can be better achieved by an operation of this kind than by resection of soft parts. In the planning of these operations radical surgery has priority. The functional results after total scapulectomy is acceptable. There is a distinct reduction of shoulder mobility, especially in abduction. As the peripheral joints are fully conserved, the extremity can be used very well in daily life. The indications for total scapulectomy and the technique are discussed with reference to two clinical cases.

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Section: Diskussionunclassified

Die skapulektomie als extremit�tenerhaltender eingriff in der chirurgie der weichteilsarkome

Zornig

Busch

Nicolas

1992

Langenbecks Arch Chir

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Metastatic paraganglioma presenting as a primary shoulder mass

et al. 2013

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Paragangliomas uncommonly metastasize, including to the bones, wherein these tumors are designated as malignant paragangliomas. A 56-year-old man presented with pain and immobility in his right arm for 1 year. He had a history of controlled hypertension and diabetes mellitus for 2 years. He had also been taking anti-anxiety medications for 25 years. His shoulder imaging revealed an expansile, lytic, destructive lesion in the glenoid cavity, measuring 4.6 × 3.9 × 3.2 cm, involving the adjacent bones and soft tissues. A whole-body PET-CT scan revealed a hypermetabolic destructive mass in the right glenoid cavity and another lesion in his abdomen in the aortocaval region. Initial biopsy and subsequent scapular resection microscopically revealed a multinodular tumor with polygonal cells arranged in a nesting and diffuse pattern, in a vascularized and sclerotic stroma. Tumor cells displayed moderate to abundant, eosinophilic to clear cytoplasm, fine nuclear chromatin, focal intranuclear inclusions, and scattered mitotic figures. Immunohistochemically, tumor cells were positive for vimentin, synaptophysin, chromogranin, and CD56 and negative for AE1/AE3, CK, EMA, CD10, SMA, Melan A, HMB-45, desmin, and S100-P. Biopsy of the abdominal mass revealed foci of tumor cells resembling the scapular tumor. Diagnosis of a malignant paraganglioma was finally offered. The patient's post-operative blood pressure is controlled. Currently, his urinary vanillylmandelic acid and metanephrine levels are normal. He is asymptomatic 11 months post-surgery and is on follow-up. This unusual case is presented to increase a diagnostic index of suspicion for a malignant paraganglioma, including at unconventional musculoskeletal sites. The diagnostic challenge and therapeutic implications are discussed herewith.

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