Skip to main content

Advertisement

Log in

Primary malignant clavicular tumours: a clinicopathological analysis of six cases and evaluation of surgical management

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Primary malignant tumours of the clavicle are extremely rare and little is known regarding their clinicopathological characteristics and outcomes of surgical management. The aim of the study is to analyse the clinical, imaging, and histological features of six patients with malignant tumours of the clavicle and present the outcome of cleidectomy in four of them. A review of the literature is also provided. Six cases were included in this series: two plasmocytomas; three PNETs, one non-Hodgkin lymphoma, one high-grade chondrosarcoma and one post-irradiation fibrosarcoma. Apart from one patient with plasmocytoma and another one with non-Hodgkin lymphoma, the remaining four patients underwent partial or complete cleidectomy according to tumour location. At the time of latest follow-up all patients were alive. Neither local recurrence nor metastases were observed in patients that underwent cleidectomy. In this group, the average score was 86.6% of the expected normal function according to the Musculoskeletal Tumour Society (MSTS) evaluation form. The mean Constant–Murley score of the affected side was 80. Patients after cleidectomy were pain free, they had almost full shoulder range of motion and no significant functional deficit was reported. Primary malignant clavicular tumours may be easily undiagnosed due to their insidious clinical onset. Partial or total cleidectomy is associated with adequate shoulder mobility and mild functional deficit. Therefore, the extent of clavicle excision during tumour removal does not seem to determine the functional outcome of the affected shoulder.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

MSTS:

Musculoskeletal Tumour Society

References

  1. Kumar R, Madewell JE, Swischuk LE, Lindell MM, David R (1989) The clavicle: normal and abnormal. Radiographics 9:677–706

    PubMed  CAS  Google Scholar 

  2. Kapoor S, Tiwari A, Kapoor S (2008) Primary tumours and tumorous lesions of clavicle. Int Orthop 32:829–834

    Article  PubMed  Google Scholar 

  3. Suresh S, Saifuddin A (2008) Unveiling the ‘unique bone’: a study of the distribution of focal clavicular lesions. Skeletal Radiol 37:749–756

    Article  PubMed  CAS  Google Scholar 

  4. Wessel RN, Schaap GR (2007) Outcome of total claviculectomy in six cases. J Shoulder Elbow Surg 16:312–315

    Article  PubMed  Google Scholar 

  5. Robinson D, Halperin N, Agar G, Alk D, Rami K (2003) Shoulder girdle neoplasms mimicking frozen shoulder syndrome. J Shoulder Elbow Surg 12:451–455

    Article  PubMed  Google Scholar 

  6. Gerscovich EO, Greenspan A, Szabo RM (1991) Benign clavicular lesions that may mimic malignancy. Skeletal Radiol 20:173–180

    Article  PubMed  CAS  Google Scholar 

  7. Gilbert NF, Deavers MT, Madewell JE, Lewis VO (2008) A 16-year-old girl with pain and swelling in the medial clavicle. Clin Orthop Relat Res 466:3158–3162

    Article  PubMed  Google Scholar 

  8. Zietz H, Berrak S, Ried H, Weber K, Maor M, Jaffe N (2001) The clavicle: a vulnerable bone in pediatric oncology. Int J Oncol 18:689–695

    PubMed  CAS  Google Scholar 

  9. Wood VE (1986) The results of total claviculectomy. Clin Orthop Relat Res 207:186–190

    PubMed  Google Scholar 

  10. Turra S, Gigante C (1988) Primary clavicular localisation of Ewing’s tumour treated by total cleidectomy. Case report and review of the literature. Ital J Orthop Traumatol 14:389–393

    PubMed  CAS  Google Scholar 

  11. Yang Q, Li J, Yang Z, Li X, Li Z (2009) Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results. Int Orthop 34(6):869–875

    Article  PubMed  Google Scholar 

  12. Enneking WF, Dunham W, Gebhardt MC, Malawer M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 286:241–246

    PubMed  Google Scholar 

  13. Minard-Colin V, Kalifa C, Guinebretiere JM, Brugieres L, Dubousset J, Habrand JL, Vassal G, Hartmann O (2004) Outcome of flat bone sarcomas (other than Ewing’s) in children and adolescents: a study of 25 cases. Br J Cancer 90:613–619

    Article  PubMed  CAS  Google Scholar 

  14. Cleeman E, Auerbach JD, Springfield DS (2005) Tumors of the shoulder girdle: a review of 194 cases. J Shoulder Elbow Surg 14:460–465

    Article  PubMed  Google Scholar 

  15. Dahlin DC, Unni KK (1986) Bone tumors: general aspects and data on 8542 cases. Thomas, Springfield, IL

    Google Scholar 

  16. Waller DA, Newman RJ (1990) Primary bone tumours of the thoracic skeleton: an audit of the Leeds regional bone tumour registry. Thorax 45:850–855

    Article  PubMed  CAS  Google Scholar 

  17. Smith J, Yuppa F, Watson RC (1988) Primary tumors and tumor-like lesions of the clavicle. Skeletal Radiol 17:235–246

    Article  PubMed  CAS  Google Scholar 

  18. Greenspan A, Unni KK, Mann J (1993) Case report 804: chondroblastic osteosarcoma grade 3 of the left clavicle. Skeletal Radiol 22:469–471

    Article  PubMed  CAS  Google Scholar 

  19. Nakazora S, Kusuzaki K, Matsubara T, Shintani K, Matsumine A, Fukutome K, Uchida A (2006) Extraskeletal myxoid chondrosarcoma arising from the clavicle. Oncol Rep 16:115–118

    PubMed  Google Scholar 

  20. Osoegawa A, Yoshino I, Yamaguchi M, Kameyama T, Kometani T, Kumamoto Y, Maehara Y (2008) Resection of radiation-induced sarcoma of the clavicle. Ann Thorac Cardiovasc Surg 14:178–180

    PubMed  Google Scholar 

  21. Varshney MK, Trikha V, Rastogi S (2007) Aggressive osteoblastoma of clavicle a rare tumor at previously undescribed site. Acta Oncol 46:259–261

    Article  PubMed  Google Scholar 

  22. Vander Maren C, Guillaumie B, Huge J, Bodart A, Van Ruyssevelt C (1994) Osteochondroma of the clavicle and pain syndrome of the shoulder. Apropos of a case. Review of the literature. Rev Chir Orthop Reparatrice Appar Mot 80:334–337

    PubMed  CAS  Google Scholar 

  23. Reichmister J, Reeder JD, Gold DL (2000) Osteochondroma of the distal clavicle: an unusual cause of rotator cuff impingement. Am J Orthop 29:807–809

    PubMed  CAS  Google Scholar 

  24. Byrd T, Gleis GE, Johnson JR (1986) Primary osteogenic sarcoma of the clavicle. A case report. Orthopedics 9:1717–1720

    PubMed  CAS  Google Scholar 

  25. Krishnan SG, Schiffern SC, Pennington SD, Rimlawi M, Burkhead WZ Jr (2007) Functional outcomes after total claviculectomy as a salvage procedure. A series of six cases. J Bone Jt Surg Am 89:1215–1219

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Barbara Rossi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rossi, B., Fabbriciani, C., Chalidis, B.E. et al. Primary malignant clavicular tumours: a clinicopathological analysis of six cases and evaluation of surgical management. Arch Orthop Trauma Surg 131, 935–939 (2011). https://doi.org/10.1007/s00402-010-1237-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-010-1237-6

Keywords

Navigation