The incidence and outcome of chondral tumours as incidental findings on investigation of shoulder pathology

Eur J Orthop Surg Traumatol. 2020 Jan;30(1):97-102. doi: 10.1007/s00590-019-02532-1. Epub 2019 Aug 17.

Abstract

Purpose: The aim of this study is to describe outcomes of incidental chondral tumours in the shoulder referred to our Bone Tumour Unit (BTU).

Methods: Our hospital radiology database was searched using the filtered terms "enchondroma", "low-grade chondral tumour", "chondrosarcoma" with "humerus", "arm", "shoulder", "scapula" and "clavicle". Case note review of results assessed primary reasons for referral, radiological diagnosis, recommended management with subsequent reviews and outcomes, either in clinic or surveillance scan reports.

Results: Ninety-nine patients had full case note review, mean age 54.5 years (range 18-84 years). Mean follow-up was 41.7 months (range 1-265 months). Over 50% of patients were referred for shoulder pain. Three patients had high-grade chondrosarcoma. Forty-three patients had interval scans, none showing any changes. Thirty-five patients had surgery for their lesions with one recurrence. Forty-four patients had alternative diagnoses made on clinical and radiological examination. At most recent follow-up, 70% of these patients were asymptomatic after physiotherapy/surgical attention to their alternative diagnoses.

Conclusions: Chondral lesions in the shoulder have low risk of malignant transformation and are rarely responsible for shoulder symptoms. We recommend patients be referred to a dedicated BTU for surveillance if there are any concerning features, but to proceed with management for any alternative diagnosis.

Keywords: Chondrosarcoma; Oncology; Shoulder.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / epidemiology
  • Bone Neoplasms / pathology*
  • Bone Neoplasms / surgery
  • Cell Transformation, Neoplastic / pathology*
  • Chondroma / diagnostic imaging
  • Chondroma / epidemiology
  • Chondroma / pathology*
  • Chondroma / surgery
  • Chondrosarcoma / diagnostic imaging
  • Chondrosarcoma / epidemiology
  • Chondrosarcoma / pathology*
  • Chondrosarcoma / surgery
  • Databases, Factual
  • Female
  • Humans
  • Incidental Findings*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / pathology*
  • Shoulder Joint / surgery
  • Survival Rate
  • Tomography, X-Ray Computed / methods
  • United Kingdom