Tumours
of the upper limb
Tumours are unusual around the elbow but the proximal humerus is a
relatively common site. It is the third most common site for both osteosarcomas
and fibrosarcomas, after the distal femur and proximal tibia. Treatment is on
conventional lines. The shoulder is the second most common peripheral site
after the proximal femur for chondrosarcomas, and the scapula body is also a
common site. The principal method of treatment for chondrosarcomas is surgical
excision and this may be technically difficult around the shoulder. Subtotal
excision of the scapula can be carried out with good preservation of function if
the glenoid can be left. The humerus is also a relatively common site for
lymphomas and Ewing’s tumour. Treatment is, again, along conventional lines.
Benign
and intermediate tumours such as osteochondromas, giant cell tumours and
aneurysmal bone cysts are also relatively common. The proximal humerus is the
most
The
humeral shaft is a common site for secondary deposits and intramedullary nailing
may be required for pathological fracture or impending fracture. The majority of
primary tumours is found in the breast or prostate, but secondary spread from
the thyroid, lung, kidney and bowel can also occur.