Management of tumors of the shoulder girdle

The differential diagnosis of all painful shoulders includes tumors of a wide variety. Evaluation of a shoulder tumor has several areas in common with other musculoskeletal neoplasms, but the function of the rotator cuff is a key consideration in treatment goals. Thorough evaluation of patients with persistent pain requires not only routine radiography, but also radionuclide imaging, computed tomographic (CT) scanning, magnetic resonance imaging, and angiography. As with all tumors, the importance of the biopsy cannot be overemphasized. A poorly executed biopsy can make limb salvage impossible. Surgical treatment of shoulder tumors will depend on age, type of tumor, extent of tumor, and neoplasm aggressiveness. Though in some instances limb sparing is not possible, a variety of reconstructive options exists that will salvage the distal limb and obtain satisfactory surgical margins.