The humerus is the longest bone in the free part of the upper limb. It belongs to the long tubular group. One of its epiphyses (heads) forms the shoulder joint, and the second – the elbow joint. Moreover, it is in this area that cysts are most often found. Most often they are diagnosed in children and adolescents, less often in adults. But in all cases, such neoplasms, although benign, require observation and treatment.
What's happened
Benign tumors, like malignant ones, can form in various parts of the body. They require removal as they cause severe complications.
Tumors in the bone and cartilage tissue of the shoulder occur in malignant or benign forms.
The disease is accompanied by pain, limited movement and joint deformation.
To identify metastases, X-rays, Doppler sonography and biopsy are prescribed. Resection of the tumor and high-intensity therapy are considered an effective treatment method.
The danger of benign and malignant neoplasms is that they may not show symptoms for a long time and proceed hidden. As they develop, they affect neighboring tissues.
That is why many tumors are established already at the second and third stages of development, when the tumor has reached a significant size and symptoms have arisen. In this case, the development of metastases to regional and distant lymph nodes is often observed.
Benign neoplasms are not so dangerous to the patient’s health, but also require removal. This is due to the fact that tumors can develop into malignant formations.
At the same time, factors such as constant injury, inflammation, penetration of pathogenic microorganisms, prolonged exposure to chemicals, toxic substances and ultraviolet rays can provoke the development of cancer cells that affect the bone tissue and joints of the shoulder.
Stages of the disease
In order to prescribe an adequate course of treatment for shoulder cancer, experts distinguish several stages of its development.
At the first stage, the neoplasm is located at the site of its initial growth, without affecting neighboring tissues. The size of the tumor does not exceed 7 cm in diameter.
At the second stage, laboratory analysis confirms the risk of possible metastasis.
When the disease reaches the third stage, pathological cells affect neighboring anatomical structures and are detected in the lymph nodes.
The fourth stage poses the greatest danger to the health and life of the patient. Metastases are found in distant internal organs and tissues of the body.
Types of shoulder tumors
Tumors that develop in the bone and cartilage tissue of the shoulder have not been fully studied. They are usually divided into malignant and benign. Each of them has certain characteristics.
Benign
They are considered the most favorable neoplasms, since they do not metastasize to neighboring organs or distant tissues. The prognosis once they are established is quite positive.
Osteoma
It grows slowly and turns into a cancerous tumor in exceptional cases. Osteoma is diagnosed in patients aged 5 to 25 years.
The pathological process is localized on the outside of the bone. In the initial stages it does not show symptoms.
Osteoid osteoma
Refers to a subtype of osteoma. The size of the neoplasm is small. The tumor has clear boundaries. The main symptom is severe pain.
In addition to the bones of the shoulder, osteoid osteoma can affect the tubular bones of the lower extremities, the bone tissue of the fingers and the wrist.
Osteoblastoma
In appearance and morphological structure it is similar to osteoid type osteoma. Features a large size. The main location of the pathological process is the femur and tibia.
Over time, when the tumor reaches a significant size, the pain intensifies. The soft tissues at the site of the neoplasm turn red and swelling is observed. With prolonged absence of medical care, atrophy occurs.
Osteochondroma
In medicine it is also called osteochondral exostosis. The lesion often affects the cartilage tissue of the shoulder joint, which is located in the tubular bones.
The tumor consists of bone and is covered with cartilage tissue. The pathological process is usually localized in the knee joint. The shoulder and spine are affected in rare cases.
The presence of a tumor in the shoulder joint provokes a violation of the motor activity of the limb. A feature of osteochondroma is the likelihood of multiple formations. This increases the risk of developing chondrosarcoma.
Chondroma
The formation begins to form from cartilage tissue. The main sites of localization of the pathological process are tubular bones, ribs, feet, shoulder joint and hands.
Chondroma poses a danger to the patient, as it most often transforms into a malignant tumor. In the initial stages, the disease occurs without symptoms.
Giant cell tumors
Diagnosed in patients aged 20 to 30 years. New growths form on the terminal segments of the bones. As they grow, they affect muscle and cartilage tissue.
The type of tumor is determined based on the results obtained during the diagnostic process.
Malignant
Tumors of a malignant course pose a danger to humans, as they can metastasize to neighboring and separated organs. In medicine, there are several types of malignant tumors.
Osteosarcoma
In medicine it is also called osteogenic sarcoma. Installed in patients aged 10 to 30 years. In this case, the disease is more often diagnosed in men. The tumor is characterized by rapid growth.
The neoplasm is localized in metaepiphryses, which belong to the bones of the legs. Often the tumor forms on the femur and tibia. The disease also affects the shoulder joint, the bone tissue of the shoulder girdle.
Chondrosarcoma
Begins to form from cartilage tissue. The disease is diagnosed in older and older male patients.
The tumor is most often located on the pelvic bones, ribs, lower extremities and shoulder joint.
Education is growing slowly. When the tumor is located on the spinal column, the disease is similar in appearance to osteochondrosis. That is why patients seek help from an oncologist in cases where the tumor reaches a significant size.
Ewing's sarcoma
Pediatric patients, mainly boys and young people, are susceptible to the development of pathology. The tumor is located on the shoulder girdle, spinal column and ribs. It can also affect the bone tissue of the shoulder joint.
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Ewing's sarcoma has an aggressive course. This is due to the early development of metastases. The main sign of the pathology is severe pain, occurring mainly at night.
Over time, as the tumor grows, the pain intensifies. In later stages, bone tissue begins to break down. Patients experience compound fractures even with minor injuries.
Reticular cell sarcoma
The formation arises from bone tissue, which is due to the fact that it is a secondary disease. This type of tumor is a consequence of metastasis of other tumors.
The main symptoms of the disease are pain and swelling of the soft tissues. Over time, when the tumor reaches a significant size, the risk of fractures increases.
In addition to primary tumors, metastatic tumors are distinguished in medicine. They arise as a result of the penetration of pathologically altered cells from other lesions.
Classification
Cancerous tumors of the shoulder are usually divided into several types, based on the type of tissue they affect.
Osteosarcoma
The tumor often forms against the background of existing benign neoplasms. Shoulder sarcoma affects bone structures, is characterized by rapid development and a high probability of metastases.
In most cases, this type of cancer is detected in the later stages of the disease.
Chondrosarcoma
The disease manifests itself mainly in people aged 40-60 years. The pathological process originates from cartilage tissue.
Develops in the presence of disturbances in the formation of the humeral bone structures. Secondary cancer of this type is rare and is found in every tenth registered patient with a malignant tumor of the shoulder.
Fibrosarcoma
This malignant neoplasm originates from fibrous connective tissue. Usually tendons, muscles and fascia are affected.
Often the disease is detected in preschool children. Fibrosarcoma is diagnosed in every second child with soft tissue tumors.
Externally, this formation looks like a rounded dense node with a bumpy surface, which is clearly separated from the surrounding tissues.
If not treated in a timely manner, the tumor gives metastases, transmitted through the blood and lymphatic system.
Histiocytoma
Pathology is observed in the tubular bone of the shoulder. A concomitant disease in most patients is Paget's disease.
People who have previously suffered fractures are at greatest risk of developing a tumor. The cancer is aggressive and often causes a secondary tumor in the lungs.
Causes
Experts have not established the exact reasons for the occurrence of malignant and benign formations. Based on many studies, a number of factors have been identified that can significantly increase the risk of tumor formation.
Genetic predisposition plays a major role in the occurrence of malignant and benign tumors. Most patients have a history of similar diseases in close relatives.
Previous injuries can also provoke the development of a tumor. A growth consisting of cancer cells begins at the site where the fracture was. This process takes about 10 years.
The development of a malignant or benign neoplasm can be provoked by periodic or single exposure to high doses.
Congenital diseases also have a significant impact on the development of neoplasms of various types in the shoulder joint. Similar pathologies include Rothmund-Thomson and Li-Fraumeni syndromes.
One of the causes of tumors may be Paget's disease. The disease is characterized by a disruption of the process of bone tissue regeneration, which leads to the appearance of various anomalies.
A bone marrow transplant operation can provoke the development of a malignant or benign tumor of the shoulder joint.
Establishing the cause of tumor development helps to significantly reduce the likelihood of tumor recurrence.
Causes of joint and bone cancer
Joint cancer can have a number of causes. Among other things, it can occur due to injuries that damage the joints. Chronic diseases are also a prerequisite for cancer.
The disease can also develop on the joint for which endoprosthetics was performed. In addition, heredity and the presence of ancestors who had a malignant neoplasm can also lead to the appearance of a tumor.
Cancer can also be caused by low levels of immunity. In addition, if this part of the body is exposed to ionizing radiation, it can lead to joint cancer.
It is also worth keeping in mind that joint cancer is divided into primary and metastatic.
- Primary cancer is a disease in which cells inside the joints initially degenerate into cancer; all of the above-mentioned causes of joint cancer are related specifically to this type.
- Metastatic cancer suggests that the original tumor originated in another tissue or organ. Subsequently, the metastases moved to the joint. Of course, the cause of joint cancer in this case will have to do with that very organ (intestines, prostate, mammary glands, lungs). It is worth noting that this type is more common, in other words, a tumor in a joint in most cases becomes a consequence of a tumor in another part of the body.
Symptoms
In the initial stages of their development, tumors, regardless of type, may not show symptoms. Certain signs appear only when the tumors reach significant sizes and the pressure on neighboring tissues increases. Among the main symptoms there are three signs.
Pain
It can be of a different nature, appear abruptly or be progressive, depending on the type and volume of the tumor.
It is localized in the place where the pathological process develops. At the initial stages of development it is insignificant and patients often do not pay attention to it.
Over time, it becomes permanent.
Painful sensations intensify mainly at night and when moving the limb, which is associated with relaxation and tension of muscle tissue. At the same time, painkillers do not bring the desired effect.
Limited shoulder mobility
Impaired performance of the shoulder joint is observed as the tumor grows. Discomfort occurs when moving the arm, flexion and extension.
Shoulder deformity
A tumor begins to appear under the skin. In this case, the upper layer of the epidermis is hot to the touch. This indicates the presence of an inflammatory process that spreads to the shoulder joint.
Over time, patients begin to experience symptoms of body intoxication. There is an increase in temperature, weight loss against the background of decreased appetite, general weakness, fatigue and irritability.
Treatment of joint cancer
The treatment of joint cancer falls under the purview of orthopedic oncology, and accordingly it is dealt with by orthopedists. Therapy for this disease is complex. Among other things, treatment of joint cancer involves radiation therapy and chemotherapy, and surgery is also possible.
In total, the process consists of three stages.
- The first stage of treatment for joint cancer consists of radiation therapy or chemotherapy sessions. At the same time, doctors strive to reduce the size of the tumor and eliminate small metastases.
- In the second stage, surgery is performed to remove the tumor and lymph nodes, followed by reconstruction to restore those parts of the body that were affected by surgery. In the treatment of joint cancer, surgery becomes the central event. Doctors strive to perform it as gently as possible, so that the least possible damage is caused to the joint with cancer, as well as to the surrounding tissues. If resection turns out to be necessary, then an implant is subsequently placed in the place from which certain tissues were removed.
- At the third stage of treatment for joint cancer, postoperative chemotherapy or radiation therapy is performed. Its purpose is to suppress tumor cells in the place where the tumor was previously excised, as well as in areas where metastases have penetrated.
Physical exercise also becomes an integral element of the treatment process for joint oncology. Since joint cancer affects the body’s motor ability, you should consult a specialist before exercising.
Diagnostics
To determine the nature of the course of the disease, a specialist conducts a thorough diagnosis. The purpose of the research is also to identify the presence of metastases and determine the extent of damage to soft and hard tissues. With a tumor of the shoulder joint of various types, the course is distinguished:
- X-ray examination. Allows you to determine the localization of the pathological process.
- Dopplerography. The scanning is carried out using a special dye, which is injected intravenously immediately before the procedure. Using a scanner, a specialist can track the movement of contrast. In this way, it is possible to determine the presence of even small formations.
- Biopsy. Patients are also prescribed a biopsy followed by histological examination. The procedure involves taking a sample of tumor tissue. Histological examination allows us to determine the presence of cancer cells.
Magnetic resonance or computed tomography is also performed. The techniques help to establish the structure of the tumor, the area of localization and other features of the course of the disease thanks to layer-by-layer scanning.
Treatment
The only effective way to treat tumors of various types is removal through surgery. Resection of benign and malignant formations is carried out using various methods depending on the characteristics of the disease, the size of the formation and the patient’s condition.
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Attention
Despite the fact that our articles are based on trusted sources and have been tested by practicing doctors, the same symptoms can be signs of different diseases, and the disease may not proceed according to the textbook.
Pros of seeing a doctor:
- Only a specialist will prescribe suitable medications.
- Recovery will be easier and faster.
- The doctor will monitor the course of the disease and help avoid complications.
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Surgical removal
The operation is performed using the classical method by removing the tumor using a scalpel. The procedure involves the use of general anesthesia.
The disadvantage of the operation is the high risk of tumor re-development. In addition, after removal, scars and scars remain on the body.
The recovery period is long. The patient can return to his work duties no earlier than 1-2 months later.
Radiation therapy
The technique involves the use of high-frequency X-ray radiation. Exposure to waves leads to the death of pathologically altered cells.
Radiation therapy is used both as an independent method and in combination with surgical removal.
Chemotherapy
The use of chemotherapy drugs for cancer is considered one of the popular treatment methods. Chemotherapy has a detrimental effect on education. The drugs are administered intravenously or intramuscularly.
The technique is often used as an additional method of therapy. Among the disadvantages of the technique are the development of side effects, such as hair loss, weight loss, and deterioration of the immune system.
High Intensity Therapy
The method involves the introduction of stem cells. This method is used in the later stages of the disease, when metastases affect the bone marrow.
The procedure is carried out in two stages: the use of chemotherapy drugs and the introduction of stem cells.
Treatment of soft tissue sarcomas
Surgery
Surgery for patients with soft tissue sarcomas involves removing the tumor within healthy tissue. If the tumor is located on the limbs or torso, then it is removed, including 2-3 cm of healthy tissue. If the sarcoma is located in the abdomen, such removal of the tumor may be impossible due to the close proximity of vital structures.
Previously, 50% of patients with soft tissue sarcomas of the upper and lower extremities underwent amputation (removal of part or all of the limb). Currently, such operations are performed in only 5% of patients. In other cases, limb-sparing operations are performed in combination with irradiation. However, the survival rate of patients did not worsen.
Amputation of a limb is recommended only if the main nerves or arteries are involved in the tumor process.
Amputation is not recommended for patients in cases of damage to distant organs, such as the lungs, when removal of the main tumor and metastases is impossible.
In this case, it is advisable to prescribe chemotherapy and radiation to shrink the tumor, and then try to perform surgery. The same tactics should be followed in patients with high-grade sarcomas, when the likelihood of metastases is increased.
If a patient has distant metastases, then, as a rule, it is impossible to cure him with surgery alone. However, with isolated lung damage, it is possible to remove metastases surgically. In such patients, the 5-year survival rate is 20-30%.
In patients with soft tissue sarcomas, external irradiation and brachytherapy (injection of radioactive material directly into the tumor) are used. Brachytherapy can be used alone or in combination with external radiation.
In some patients who cannot undergo surgery for health reasons, radiation therapy is used as the primary treatment.
After surgery, radiation is used to destroy the remaining part of the tumor that could not be removed by surgery.
Radiation therapy may be used to reduce symptoms of the disease.
Skin changes and increased fatigue may occur during radiation treatment. These phenomena disappear after cessation of treatment.
Radiation may increase the side effects associated with chemotherapy. Radiation therapy to the abdomen may cause nausea, vomiting, and loose stools (diarrhea). Radiation exposure to the lungs can cause lung damage and shortness of breath. Large volume radiation therapy to the extremities may be accompanied by swelling, pain, and weakness.
In rare cases, a bone fracture may occur after irradiation of the extremities. Side effects from the brain when it is irradiated for metastases may appear after 1-2 years in the form of headaches and deterioration in thinking.
Chemotherapy (drug treatment) in patients with soft tissue sarcomas can be used as the main or auxiliary treatment (in combination with surgery), depending on the extent of the tumor. Typically, chemotherapy consists of prescribing a combination of anticancer drugs.
The most commonly used combination is ifosfamide and doxorubicin, but other drugs can also be used: dacarbazine, methotrexate, vincristine, cisplatin, etc. To prevent bladder complications when using ifosfamide, the drug mesna is used.
During chemotherapy, tumor cells are destroyed, but normal cells in the body are also damaged, which leads to temporary side effects such as nausea, vomiting, loss of appetite, baldness, and the formation of mouth ulcers.
Suppression of hematopoiesis may be accompanied by increased susceptibility to infection and bleeding.
The most serious complications of chemotherapy include damage to the heart muscle due to the use of doxorubicin and infertility due to impaired ovarian and testicular function.
In case of recurrence of sarcoma in the area of the primary lesion, surgery can be used.
Another treatment option may be radiation therapy, especially in cases where radiation has not previously been used. If the patient has already received external irradiation, then brachytherapy can be recommended.
Radiation therapy may be given to relieve pain if the sarcoma recurs.
In patients with distant metastases, chemotherapy is prescribed, and in case of single metastases, surgery may be recommended.
Complications
Lack of therapy, especially in the last stages of tumor development, leads to a number of complications.
First of all, metastasis to distant tissues and organs, including the brain, is distinguished. In this case, there is a decrease in memory, concentration, coordination of movements, deterioration of vision, and psychomotor reactions.
In later stages, the risk of death or disability increases when, in the presence of a large tumor, amputation of a limb was performed.
Possible complications and prognosis
The most common complication of a cancerous tumor of the shoulder is infectious infection of the tissue, which subsequently led to amputation of the arm.
In addition, a malignant neoplasm at stages 3–4 gives metastases to regional lymph nodes and distant anatomical structures. The result of this pathological process is the establishment of disability or death.
The prognosis of the treatment process is individual and is largely related to the patient’s general health, age, level of immunity, stage of cancer development and the presence of metastases.
The most successful treatment for the patient is considered to be the beginning of treatment for the pathology in the first stages of its development. In this case, the probability of getting rid of cancer is at least 80%.
When a secondary neoplasm is detected, the chances of recovery are significantly reduced. According to statistics, in this case, life expectancy is no more than 1 - 1.5 years.
Prevention
There are no special measures to prevent neoplasms, regardless of the nature of their course. Doctors recommend regular medical examinations. Timely diagnosis will make it possible to identify pathology in the early stages of development.
Malignant and benign tumors of the shoulder joint are not a common disease. The danger of pathology, especially in the presence of cancer cells, is that the formation can metastasize and affect neighboring tissues and organs. That is why you should not delay treatment and consult a doctor if symptoms appear.