obsolete malignant neoplasm of scapula and long bones of upper limb

Obsolete Malignant Neoplasm of Scapula and Long Bones of Upper Limb

The term "obsolete malignant neoplasm of scapula and long bones of upper limb" refers to a type of cancer that affects the scapula (shoulder blade) and long bones of the upper arm. This condition is no longer considered current or relevant in medical practice, as indicated by its obsolete status.

Definition

According to the provided context [10][11], this term is defined as a malignant neoplasm (cancerous growth) that occurs in the scapula and long bones of the upper limb. The exact definition is not specified, but it implies a serious and potentially life-threatening condition.

Synonyms

The synonyms for this term include "malignant neoplasm of scapula and long bones of upper limb" [10][11], indicating that these terms are equivalent or related to the original description.

References

The references provided in the context [10][11] suggest that this term was previously used in medical literature, but it is no longer considered relevant or current. The exact sources are not specified.

Ontology

The ontology associated with this term indicates that it is a type of disorder or condition affecting the human body [10].

Overall, the description of obsolete malignant neoplasm of scapula and long bones of upper limb suggests a serious and potentially life-threatening cancerous growth in the scapula and long bones of the upper arm. However, due to its obsolete status, this term is no longer considered relevant or current in medical practice.

Based on the search results, here are the signs and symptoms of malignant neoplasms of the scapula and long bones of the upper limb:

Common Symptoms:

• Pain in the affected bone is often the most common and noticeable symptom [1].
• Swelling or lump near the site of the tumor [1].
• Systemic symptoms such as fever, fatigue, anorexia, and weight loss are associated with disseminated metastases, seen in 10–30% of patients at initial diagnosis [6].

Specific Symptoms for Scapula:

• The scapula is a small irregular-shaped flat bone that may suffer from a variety of tumors or tumor-like lesions [10].
• Imaging manifestations can be complex and changeable, making correct imaging diagnosis difficult [10].

Symptoms for Long Bones of Upper Limb:

• Pathological fractures are caused by many reasons such as osteomyelitis, bone tumors, and osteoporosis [5].
• Pain and swelling in the affected limb are common symptoms [5].

Other Symptoms:

• Neurologic complications of systemic cancer can experience severe weakness, dementia, seizure activity, loss of ambulation, pain, and incontinence [8].
• Fibrosarcoma starts in the connective tissue–building cells and can grow in soft tissues in middle-aged adults, causing pain and swelling [12].

References:

[1] - Persistent Bone Pain: Pain in the affected bone is often the most common and noticeable symptom. [5] - Pathological fractures are caused by many reasons such as osteomyelitis, bone tumors, and osteoporosis. [6] - Systemic symptoms of fever, fatigue, anorexia, and weight loss are associated with disseminated metastases, seen in 10–30% of patients at initial diagnosis. [8] - Neurologic complications of systemic cancer can experience severe weakness, dementia, seizure activity, loss of ambulation, pain, and incontinence. [10] - The scapula is a small irregular-shaped flat bone that may suffer from a variety of tumors or tumor-like lesions. [12] - Fibrosarcoma starts in the connective tissue–building cells and can grow in soft tissues in middle-aged adults.

Diagnostic Tests for Malignant Neoplasm of Scapula and Long Bones of Upper Limb

The diagnosis of a malignant neoplasm in the scapula and long bones of the upper limb typically involves a combination of imaging tests, laboratory studies, and histopathological examination.

• Imaging Tests: Plain radiography is often the first diagnostic test used to evaluate bone lesions. It can reveal features such as sunburst appearance, Codman's triangle, and new bone formation [4]. Computed tomography (CT) scans and magnetic resonance imaging (MRI) are also useful in assessing the extent of disease and planning treatment [8].
• Blood Tests: While blood tests are not necessary for diagnosis, they may be helpful once a diagnosis is made to assess overall health. Tumor markers such as osteocalcin may be analyzed in blood tests for bone cancer diagnosis [11].
• Biopsy: A definitive diagnosis can be established by incisional biopsy and histopathological evaluation [5]. Fine needle aspiration biopsy is a safe and cost-effective method for obtaining tissue samples.
• Imaging Studies: Imaging studies such as CT, MRI, and positron emission tomography (PET) scans are helpful in evaluating the extent of disease and planning treatment [8].
• Multidisciplinary Evaluation: A multidisciplinary team of experts uses a variety of tests and tools for diagnosing bone cancer, evaluating the disease, determining the affected bone(s), and developing an individualized treatment plan [13].

Key Diagnostic Tests

• Plain radiography
• CT scans
• MRI
• Biopsy (incisional or fine needle aspiration)
• Blood tests (to assess overall health and tumor markers)

These diagnostic tests are essential for accurate diagnosis and planning of treatment for malignant neoplasm of the scapula and long bones of the upper limb.

References:

[4] Kundu ZS. Diagnostic features of bone malignancies on plain radiographs. Journal of Bone Oncology, 2014; [cited by 194]

[5] Qiang S. Definitive diagnosis of bone cancer: A review of diagnostic methods. Journal of Orthopaedic Surgery and Research, 2019; [cited by 8]

[8] Multimodality imaging for bone cancer diagnosis. Mayo Clinic Proceedings, May 17, 2022

[11] Tumor markers in blood tests for bone cancer diagnosis. American Cancer Society, 2024

[13] A multidisciplinary approach to diagnosing and treating bone cancer. Journal of Bone Oncology, 2024

Treatment Options for Malignant Neoplasms of Scapula and Long Bones of Upper Limb

The treatment options for malignant neoplasms, such as osteosarcoma and chondrosarcoma, affecting the scapula and long bones of the upper limb have evolved over time. While some treatments may be considered obsolete, others remain relevant.

• Chemotherapy: Chemotherapy is still a viable option for treating primary bone cancers or those that have spread. It can be used in conjunction with other treatments such as surgery and radiotherapy.
• Radiotherapy: Radiotherapy is also used to treat malignant neoplasms of the scapula and long bones of the upper limb, particularly in cases where surgery is not feasible or has been unsuccessful.
• Targeted Therapy: Targeted therapy using monoclonal antibodies like denosumab (Xgeva) may be used to treat certain types of bone cancer. This treatment works by targeting specific cells involved in the growth and spread of cancer.

Obsolete Treatment Options

While these treatments are no longer considered first-line options, they may still have a place in certain situations:

• Bisphosphonates: While bisphosphonates are still used to help manage and prevent problems associated with bone metastases, their use as a primary treatment for malignant neoplasms of the scapula and long bones of the upper limb is less common.
• Surgery: Surgery remains an important treatment option for many types of cancer, including those affecting the scapula and long bones of the upper limb. However, the specific surgical approaches may have evolved over time.

Current Treatment Paradigm

The current treatment paradigm for malignant neoplasms of the scapula and long bones of the upper limb often involves a multidisciplinary approach, incorporating surgery, radiotherapy, chemotherapy, and targeted therapy as needed.

• Limb Salvage Surgery: Limb salvage surgery is still performed in cases where possible, followed by adjuvant treatments such as radiotherapy and chemotherapy.
• Adjuvant Therapy: Adjuvant therapies like chemotherapy and radiotherapy are used to reduce the risk of cancer recurrence after surgery.

References

[1] Treatment options for metastatic bone disease often dependent upon which bone(s) have been affected by the spread of cancer. [8] [2] Medicines may be given to try and strengthen the bones which can help prevent fractures (see Drugs to treat bone metastases below). Cancer in the scapula or long bones of the upper limb may require specialized treatment approaches. [9] [3] Bisphosphonates are drugs that help slow the breakdown of bone. They are standard therapy for bone metastases. [10] [4] Treatment includes radiation therapy and chemotherapy. In summary, the scapula may contain a wide range of benign and malignant tumors, many of which have specific treatment approaches. [7] [5] Limb salvage surgery was performed, followed by adjuvant radiotherapy, chemotherapy, and autologous stem-cell transplantation. The patient is disease free with no evidence of recurrence. [4] [6] Surgery remains the primary modality of treatment for chondrosarcoma. Radiotherapy is used as an adjuvant therapy in high-grade tumours and in cases of residual disease. [5] [7] Denosumab (Xgeva) is a monoclonal antibody that doctors use in targeted therapy. The U.S. Food and Drug Administration (FDA) have approved it for the treatment of bone metastases. [6]

The differential diagnosis for an obsolete malignant neoplasm of the scapula and long bones of the upper limb involves considering various conditions that may present with similar symptoms and imaging characteristics.

According to the search results, the differential diagnosis primarily consists of other "small round cell" lesions, including:

• Neuroblastoma metastases
• Lymphoma
• Primitive neuroectodermal tumor (PNET)
• Ewing's sarcoma

Additionally, infections such as osteomyelitis and eosinophilic granuloma may also be considered in the differential diagnosis. These conditions can mimic a malignancy and have an aggressive growth pattern.

It is essential to note that the scapula is a small irregular-shaped flat bone that may suffer from various tumors or tumor-like lesions, making correct imaging diagnosis challenging [13]. A thorough analysis of the imaging signs of different types of benign and malignant tumors is necessary for accurate diagnosis.

In some cases, a winged scapula following axillary thoracotomy with long thoracic nerve preservation may also be considered in the differential diagnosis [15].

References:

• [3] The differential diagnosis primarily consists of the other “small round cell” lesions (neuroblastoma metastases, lymphoma, primitive neurectodermal tumor, and Ewing's sarcoma).
• [11] It is a feature of malignant bone tumors. There are two tumor-like lesions which may mimic a malignancy and have to be included in the differential diagnosis. These are infections and eosinophilic granuloma.
• [13] The scapula is a small irregular-shaped flat bone, which may suffer from a variety of tumors or tumor-like lesions.
• [15] Winged scapula following axillary thoracotomy with long thoracic nerve preservation.