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Proximal humerus pathological fracture due to metastatic renal cell carcinoma
*For correspondence: vijaytkt@yahoo.co.in
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 52 yr old male† presented to the department of Orthopaedics, Christian Medical College, Vellore, India, in September 2019, with complaints of dull-aching pain in the right shoulder for three months, aggravated on exertion, and relieved by rest and analgesics with pain in the night. He had undergone open radical nephrectomy with inferior vena cava (IVC) thrombectomy on June 5, 2018 for right renal cell carcinoma (RCC) with IVC thrombosis. On examination of the right shoulder, diffuse swelling associated with severe tenderness was present on the proximal humerus. There was no obvious deformity and the range of movements were restricted only due to severe pain. X-ray and magnetic resonance imaging (Figs 1, 2A & B) showed a lytic mass with pathological fracture of the right proximal humerus. Open biopsy showed features of metastatic RCC. F18-PET bone scan showed right humerus metastasis. Right proximal humerus excision with mega prosthesis was done (Fig. 3), and the patient's condition improved.
- X-ray showing pathological fracture due to metastatic renal cell carcinoma (arrow).
- Magnetic resonance imaging in (A) anteroposterior and (B) axial view showing proximal humerus fracture with metastatic renal cell carcinoma.
- Postoperative X-ray after proximal humerus excision with mega prosthesis.
Conflicts of Interest: None.
