The Shoulder Pain due to Metastatic Breast Cancer -A Case Report-

Extraspinal Percutaneous Osteoplasty for the Treatment of Painful Bony Metastasis

BACKGROUND

Extraspinal percutaneous osteoplasties (POPs) are novel techniques for the treatment of painful bony metastasis, which is often the cause of both persistent and incidental breakthrough pain. This retrospective study explored the efficacy and complications of extraspinal POPs.

METHODS

The origin of the cancer metastasis, performed POP sites, necessity of adjacent joint injections, pain and Karnofsky Performance Scale (KPS) scores, complications related to the POPs, and life expectancy were evaluated from the medical records from 2009 to 2016.

RESULTS

A total of 47 (M/F = 28/19) patients had received 54 POPs, including costoplasty, scapuloplasty, ilioplasty, humeroplasty, ischioplasty, femoroplasty, sternoplasty, and puboplasty, in order of frequency. The most common sites for the origin of the cancer, in order of frequency, were the lung, liver, breast, colon, and kidney. All patients receiving POPs including scapuloplasty, ilioplasty, humeroplasty, and femoroplasty needed adjacent joint injections before or after the POPs. Pain due to metastatic lesions was reduced significantly immediately after the POPs and the reduction was sustained until the end of their lives. The median KPS was increased from 35.4% to 67.7% immediately after the POPs. There were no complications related to the procedures. The mean life expectancy after performing the POPs, for 35 patients which died afterwards, was 99.3 days, ranging from 1 to 767 days.

CONCLUSION

Even though pain in the isolated POP sites may be difficult to measure due to overlapping systemic pain, the POPs provided immediate local pain relief, and the patients showed better physical performance without procedure-related complications.

Frozen shoulder and risk of cancer: a population-based cohort study

Background:

Frozen shoulder might be a complication or a presenting symptom of cancer. We examined the risk of a cancer diagnosis after an incident diagnosis of frozen shoulder.

Methods:

We used prospectively collected data from Danish registries to identify patients with frozen shoulder during 1995–2013 and followed them for the development of cancer.

Results:

We observed 2572 incident cancers among 29 098 frozen shoulder patients. The expected number of incident cancers in the general population was 2434. The 6-month cumulative incidence of any cancer was 0.70%, corresponding to a standardised incidence ratio (SIR) of 1.38 (95% confidence interval (CI): 1.19–1.58). Risk increases were highest for lung cancer (SIR=2.19, 95% CI: 1.48–3.13), breast cancer (SIR=1.51, 95% CI: 1.02–2.15), and non-Hodgkin’s lymphoma (SIR=2.28, 95% CI: 1.09–4.20). The cumulative incidence of any cancer during the remainder of follow-up (>6 months to a maximum 18.9 years) was 24.8% with an SIR of 1.04 (95% CI: 1.00–1.08).

Conclusions:

Frozen shoulder might be an early predictor for a subsequent cancer diagnosis.