Shoulder swelling symptoms. Joint cancer

When atypical cells appear in the musculoskeletal system, cancer of the joints and bones develops. This is due to constant injury or with a genetic predisposition to the development of a malignant process. In this case, patients feel severe pain and deformation of bone structures.

Etiology and risk group

There is no unified theory of the development of oncological diseases. There is an assumption that cancer is the result of a malfunction in the human immune system, in which it ceases to distinguish and destroy defective cells. It is cellular mutants that begin to multiply intensively, depleting the energy reserves of the host organism, and this ultimately leads to the death of the patient. However, the causes of malignant formations are not fully understood.

There are a number of predisposing factors that can cause joint cancer damage:

• past trauma.
• exposure to ionizing radiation in high doses.
• genetic predisposition.
• the presence of genome disorders.
• Paget's disease.
• performed bone marrow transplant.

Types of joint cancer and symptoms

More primitive atypical cells cause rapidly progressive and malignant cancer.

Damage to bones and joints can occur in various ways and have completely different external manifestations. Therefore, the signs of cancer are divided into several types. From this, an approach to treatment is chosen and a further course is predicted along which oncology develops. However, regardless of the type of cancer, the outcome of cancer always consists in the germination of the tumor into neighboring organs, disruption of their function, and subsequent death of the patient.

Chondrosarcoma

This is a common malignant neoplasm that affects cartilage tissue. Its predecessor is hemangioma. Since the tumor is found in the tubular bones, it causes cancer of the shoulder, pelvis and hip bones. Sometimes the development of chondrosarcoma is associated with the degeneration of benign formations. Depending on the degree of malignancy, as well as structural features, the course of the disease is mild and slowly progressive or severe. This cancer develops in adults. The main complaint of those suffering from this problem is pain at the site of the pathological process. When the tumor reaches a large size, a visible deformation appears.

Ewing's sarcoma

A feature of this type of bone cancer is the development of the process in adolescence. The tumor is aggressive and is characterized by early metastasis. The neoplasm is localized in the diaphysis and femoral neck, and metastases are formed in the lungs and nervous tissue. The disease is hereditary, and the impetus for its occurrence is trauma.

fibrosarcoma

A malignant formation of connective tissue is more often formed in the muscles, but over time it affects nearby bones. Occurs in the hip joint due to the large number of surrounding soft tissues. These tumors are non-aggressive and can exist in the body for a long time without causing symptoms. If the tumor is located close to the surface, then as a result of growth, a bump appears on the skin. In the early stages, fibrosarcoma does not cause severe pain.

osteosarcoma

It has great aggression and is the most common neoplasm that affects bone tissue. It appears more often in young patients, causing cancer of the shoulder joint and bone, as well as other tubular bone elements of the skeleton. It is localized mainly in the metaphysis. Significant anxiety of patients is caused by dull constant pains, which eventually become excruciating. Limb deformities or pathological fractures may develop.

Metastases

The spread of cancer throughout the human body occurs through the lymphatic and blood vessels. The first signs of this appear in the regional lymph nodes, which increase, accumulating atypical cells in themselves. Through the vascular bed, a malignant formation more often enters the lungs, where its daughter tumors, metastases, are formed. After the cells enter the nervous tissue, brain, liver and other organs. Sometimes the malignant process is noticed very late, so it is almost impossible to distinguish metastases from the primary tumor without a more detailed analysis.

How to diagnose?

Symptoms of cancer can be detected by a doctor during a routine examination or as a result of complaints from a patient. To confirm the diagnosis, laboratory research methods are used - a general blood and urine test. The patient is also shown x-rays and computed tomography, which help to see the boundaries that have oncological formations. After that, the patient undergoes a biopsy of the formation - taking a small fragment of the tumor. The resulting material is taken for microscopic examination, where the type of cells and their degree of malignancy are determined.

Timely diagnosis of a neoplasm will help to permanently get rid of this problem and avoid a fatal outcome for the patient.

Bone cancer (or bone cancer, or bone tumor) is a general term used to address neoplasms of a benign (with the possibility of degeneration) and malignant type. Bone cancer, which presents differently depending on the type of cancer, may present with minor symptoms in the early stages and is therefore often ignored by patients. Remarkably, bone oncopathology itself is diagnosed quite rarely (about 1% of tumors), however, due to the formation of a tumor in a particular organ or system, and metastasis to the bones, certain types of cancer belong specifically to bone cancer.

general description

Bone cancer is one of the most rarely diagnosed types of cancer. Basically, this disease affects children and adolescents, much less often bone cancer is diagnosed in older people. Bone damage mainly occurs due to metastasis from cancer in other areas (with cancer of the breast, lungs, etc.). Depending on this, the disease is designated as primary or secondary. Primary bone cancer develops on its own. Secondary bone cancer (or, as it is also called, metastatic bone cancer) develops in the previously indicated variant, that is, in those cases when cancer cells from other areas enter the bone tissue.

We remind our readers what metastasis is. Metastasis refers to a process in which secondary foci of tumor growth begin to form, that is, metastases. Metastases begin to form due to the spread of cells that contribute to this to other areas and tissues from the area of ​​\u200b\u200bthe primary (main) location of the tumor. It is on the basis of such a process as metastasis that there are reasons to indicate the malignant nature of the tumor disease. At the same time, metastasis excludes the possibility of curing an existing tumor without removing the metastases themselves. Often, it is precisely because of the damage to a number of internal organs (brain, liver, etc.) caused by metastases that tumors become incurable.

The disease, which we will focus on today, develops when bone cells begin to divide uncontrollably and randomly. Cancer cells grow directly in the bone tissue. With the continuation of uncontrolled division, that is, when there is no need for new cells, but they still continue to divide, an outgrowth is formed - this is a tumor. Also, neoplasm cells can grow into tissues located in their immediate vicinity, as well as spread to other parts of the body. This picture corresponds to a malignant tumor formation, but if the tumor is benign, then such a spread to other organs does not occur.

Depending on the characteristics of the lesion, the corresponding types of bone cancer are distinguished, we will consider them below.

Bone cancer: types and features

As we have already indicated, bone tumors can be benign and malignant. In listing the options, we will not dwell on their characteristic symptoms, but only highlight their inherent features for a general idea.

Benign tumors include:

• In this case, the tumor, as already indicated, is benign. It is characterized by a favorable course, it grows very slowly, is not predisposed to malignancy, does not grow into nearby tissues, and is not prone to metastasis. It is mainly diagnosed in children and young people (general age group - patients 5-20 years of age). Osteomas have certain types of forms, their difference is the area of ​​localization and structure. In particular, these are hyperplastic osteomas formed on the basis of bone tissues (osteoid osteomas, osteomas), as well as heteroplastic osteomas formed on the basis of connective tissue(osteophytes). Tumors are mainly localized from the side of the outer bone surface with localization in the area of ​​the flat bones of the skull, on the humerus, femur and tibia, on the walls of the frontal, ethmoid, maxillary and sphenoid sinuses. The vertebral bodies may also be affected. As a rule, osteomas are single in nature of manifestation, however, exceptions are allowed. As such, it is considered Gardner's disease accompanied by the formation of multiple tumor formations, as well as congenital osteomas with damage to the bones of the skull. The latter develop due to a violation in the development of mesenchymal tissues, appear in combination with a number of other defects. Osteomas themselves are not painful, their presence is not accompanied by any symptoms, however, until nearby anatomical formations begin to be compressed, this can already cause the manifestation of a wide variety of symptoms, ranging from visual impairment to the development of epileptic seizures. Treatment of osteomas is performed only by surgical intervention.
• Osteoid osteoma (aka osteoid osteoma). Such a neoplasm is mostly single, its diameter does not exceed 1 centimeter. Its contours are clear, the area of ​​localization is possible in any of the bones of the skeleton (exceptions are the sternum and bones of the skull). Based on statistics for this type of tumor, they are diagnosed on average in 11% of cases of benign tumor formation. In most cases, the femur is affected, followed by the tibia, and finally the humerus, according to the frequency of detection of osteomas. Difficulties in diagnosis arise due to the small size of the tumor formation, as well as due to the absence of specific symptoms. Because of this, often the treatment of osteoid osteoma is carried out on the basis of an incorrect diagnosis, and, accordingly, unsuccessfully. The only method of treatment is surgical intervention, its volume is determined based on the area of ​​localization and on the specific type of tumor process. Such formation after removal, as a rule, is not subject to recurrence.
• Osteochondroma (aka - ectostosis). In this case, we are talking about a tumor formation, which manifests itself as an outgrowth based on bone tissue, which is, as it were, covered with a “cap”, this time based on cartilage tissue. Osteochondroma has the appearance of a colorless mass in its structure. It is mainly detected in patients aged 10-25 years. A neoplasm of a similar type, which can be designated as an osteophyte, has nothing in common with the considered tumor formation in terms of pathogenesis (features of the course of the disease, what happens during it). Osteophytes are formed near the affected joint in a disease such as osteoarthritis. In other words, it is wrong to attach an osteophyte to osteochondroma, they are not synonyms. As for the areas of localization, here the picture can be different, although in about half of the cases, a lesion of the lower femur, a lesion of the upper tibia, and a lesion of the upper humerus are diagnosed. Detection is allowed in other bones, except for the defeat of the facial bones of the skull. The feet, hands and spine, meanwhile, are rarely affected. The diameter of the tumor can reach 14 centimeters, with the maximum period of observation of patients, there were no cases of malignancy of the process, the probability of such a variant, meanwhile, is 1-2%. Recurrence is also possible, mainly observed during the first 26 months after surgical removal of the tumor. A similar option is possible with incomplete removal of the tumor or with incomplete removal of its cap. Treatment of osteochondroma is carried out only with a radical effect, that is, with surgical removal of the tumor.
• Chondroma. Chondroma can also be referred to as a cartilage tumor or cartilage, which, as you can understand, determines the structural features of such a tumor - it consists of cartilage tissue. Based on the localization of the bone, enchondroma and ecchondroma are distinguished. Enchondroma is formed directly in the bone, which is accompanied by a practical bursting of the latter with the growth of the tumor. Echondroma grows from the bone, towards the soft tissues, that is, beyond the limits of the bone to which it refers. Chondromas in their localization often affect the bones of the feet and hands, somewhat less often flat and long tubular bones are affected. Symptoms are scarce, pain, as one of the symptoms, appears mainly as a result of injuries or as a result of pathological fractures due to the growth of the presence of a tumor process in the bone (which is important when localized in the region of the distal extremities). Treatment of chondromas requires surgical intervention, in which the tumor is removed and the defect is repaired. Malignancy of the process occurs mainly with large tumors concentrated in the pelvic bones and in long tubular bones. In general, the prognosis is favorable.
• Chondromyxoid fibroma. This type of tumor formation is quite rare, it is benign. Basically, long tubular bones are subject to damage with it, although damage to other bones of the skeleton is not excluded. As a rule, the course of the disease is characterized as favorable, although the possibility of recurrence and even malignancy is allowed. The manifestation of chondromyxoid chondroma is accompanied by the occurrence of increasing pain sensations, which are noted where, in fact, the tumor appeared. In a severe variant of the course, muscle atrophy may develop in the area of ​​the affected limb, and the mobility of the joint located in close proximity to the tumor may also be limited. Quite often the tumor is found in a tibia, in a calcaneus. It can affect the pelvic, shoulder bones, ribs, skull bones, sternum, vertebrae. The most aggressive tumor growth is in the spinal cord. Chondromyxoid fibroma, the symptoms of which are detected with the same frequency in both men and women, develops in patients of any age. In particular, severe symptoms and the most rapid growth of the tumor are detected in children. In about 15% of cases, the course is characterized by the absence of symptoms as such, while the detection of the tumor occurs by chance, during an X-ray examination in the direction of an orthopedist or traumatologist.
• Chondroblastoma. This type of tumor formation is similarly benign, however, there are certain deviations for this statement. To begin with, let us denote that such a tumor is formed due to cartilaginous tissue, concentrating in the epiphyseal region of tubular long bones. The distal epiphysis of the femur is in first place in terms of the part of the lesion, the proximal epiphysis with a lesion of the tibia is in the second place, and, finally, the proximal epiphysis with a lesion of the humerus is in third place. Somewhat less often, chondroblastomas are detected in the proximal epiphysis of the femur, in the bones of the foot and pelvis. In practice, there are also cases of chondroblastomas appearing on the side of the ribs, sternum, spine, scapula, collarbone, patella, wrist bones, phalanges of the fingers, as well as in the cranial vault and lower jaw. Most often, this disease is diagnosed after the age of 20 years, somewhat less often - in adulthood and in the elderly. For various age groups, there are data on chondroblastoma, indicating that it is diagnosed on average in 1-4% of cases of possible benign tumor formations. There is also a predisposition of men to this type of tumor - they are diagnosed on average 2 times more often than, respectively, in women. It should be noted that chondroblastoma can be not only benign, but also malignant. In this case, benign chondroblastoma can manifest itself either in a typical form or in a mixed form. There are also some varieties of both types of tumors. So, benign chondroblastomas can manifest themselves in the following varieties: cystic chondroblastoma, chondromic chondroblastoma, chondroblastoma with chondromyxoid fibroma or osteoblastoclastoma. In turn, malignant chondroblastomas can manifest themselves in such varieties: clear cell chondrosarcoma, primary malignant chondroblastoma or malignant chondroblastoma (in the latter version, it can also be transformed into chondrosarcoma or osteogenic chondroblastic sarcoma). Malignant forms of chondroblastoma are diagnosed in approximately 7% of cases of chondroblastoma in general (that is, including benign ones). Malignancy mainly occurs against the background of several previous relapses of the benign form of the disease, which in particular is due to its incomplete surgical removal.
• Giant cell tumor (also known as osteoblastoclastoma or osteoclastoma). Such a bone tumor is diagnosed most often. There are no special differences in the predisposition of men or women to this disease, therefore it can be added that both sexes are equally susceptible to it. There is also a hereditary predisposition. As for age predisposition, in general, the disease can be detected from 1 to 70 years, however, in more than half of the cases of giant cell tumor detection, the age of 20-30 years can be designated as the peak of age-related incidence. At the same time, it can be added that in children under twelve years of age, the tumor is detected extremely rarely. Basically, the tumor formation is solitary, in some cases its double concentration is detected, and mainly in the bones located near. More often, long tubular bones are affected, which is relevant in an average of 74% of cases, small and flat bones are affected less frequently. Localization of the tumor in long tubular bones is noted in the epimetaphyseal region. It does not grow into the epiphyseal and articular cartilage. In 0.2% of cases, which is quite rare, the localization is diaphyseal. A benign tumor can transform into a malignant one, in addition, osteoblastoclastoma can be primary malignant. Malignant osteoblastoclastomas are localized similarly to benign tumor formations of this type. Bone tissue is subject to destructive processes. The composition of the tumor includes giant multinucleated cells, as well as unicellular formations, while giant cells play a less significant role in the development of tumor formation in comparison with unicellular ones. The cellular origin of the tumor formation is generally unknown. The clinical course is characterized by its own slowness, the pain manifests itself late and is of a moderate nature. Swelling of the bone and its deformation are observed in the later stages of the course of the disease. The process of metastasis is accompanied by spread both to the surrounding veins and to distant veins, for example, to the lungs. Here they retain a benign structure, however, they have the ability to produce bone tissue. Osteoclastoma forms in areas that are referred to as bone growth zones. In particular, this is the neck and head of the femur, the greater or lesser trochanter of the femur. The tumor can completely affect the articular end of the bone, thereby contributing to its swelling or destruction of the cortical layer, after which it goes beyond the affected bone. In some cases, the destruction of the bone by the tumor occurs in an uneven way, the clinical and radiological features when examining it indicate either its cellular-trabecular structure or the complete disappearance of the bone under the influence of the growth of the tumor process - in this case we are talking about the lytic form. Remarkably, the lytic form develops in pregnant women, and the process of tumor development is so rapid and vivid in its clinical picture that this form is diagnosed as malignant. Treatment in this case involves termination of pregnancy, although in practice there have been cases of detection of a tumor in the final months of pregnancy, and therefore treatment began after childbirth. If earlier this tumor was considered benign, now the prevailing idea about it has been revised, taking into account its possible primary malignant nature and tendency to malignancy. A number of questions on it, in addition, remain unclear.
• Angioma. In this case, we are talking about a generalized definition for a group of vascular tumors that form on the basis of lymphatic or blood vessels. The localization of such neoplasms can be superficial (mucous membranes or skin are affected), in addition, they can be located in the internal organs and muscles. The accompanying manifestations of their existence are bleeding, they, in turn, can manifest themselves in varying degrees of their own intensity. Removal of such neoplasms is carried out by various methods (X-ray therapy, sclerotherapy, cryotherapy), and surgical intervention is also a possible measure. Various organs and tissues are subject to damage, while angiomas can be either single or multiple. Sizes may also vary. If a case of hemangioma (an anomaly with damage to the blood vessels) is considered, then the neoplasms have a blue-red color, and if lymphangiomas (an anomaly with damage to the lymphatic vessels), then such neoplasms are colorless. Basically, angiomas are found in children - they account for about 80% of cases of congenital forms of neoplasms. It should also indicate a predisposition to progression, and sometimes to a very rapid one. Angiomas are mainly found in the region of the upper half of the trunk, on the neck and on the head. The eye sockets, eyelids, lungs, pharynx, external genital organs, bones, liver, etc. are somewhat less commonly affected. Basically, angiomas are congenital, and their increase is due to the growth of blood vessels in the tumor itself. These vessels grow into the tissues surrounding them, thereby destroying them, which is similar to the growth of tumor malignant neoplasms.
• Myxoma. Myxoma is an intracavitary tumor that affects the heart. This tumor is benign, and of all the varieties of this type of tumors, it is detected in 50% of cases in adult patients, in 15% in pediatric patients. At the same time, in 75% of cases, the localization of the tumor formation falls on the left atrium, in 20% of cases - on the right. A small proportion of cases occur in the valvular apparatus or in the ventricles. The main age of patients is 40-60 years. Most often, myxoma of the heart is diagnosed in women than in men. The tumor itself is formed on the basis of connective tissue, it also contains a significant amount of mucus. In addition to damage to the heart, myxoma can also be detected on the extremities, in the area of ​​intermuscular tissue, fascia and aponeuroses. Somewhat less commonly, the nerve trunks and bladder are affected.
• Fibroma. Fibroma is a benign mature tumor based on connective tissue. It can form in any part of the body. May be diffuse or limited. The course of the disease and its signs directly depend on where the fibroma is located, as well as on the characteristics of the growth rate. The possibility of transformation from a benign formation to a malignant formation is allowed. Fibroma is treated surgically.
• Eosinophilic granuloma. This disease is designated as a pathology of an unclear nature, the course of which is characterized by the formation of granulomas (infiltrates) in the bones, while a feature of the granulomas is the presence of a significant amount of eosinophilic leukocytes in them. Some authors believe that the disease has an infectious-allergic nature, some - that it is associated with trauma, some - with helminthic tissue invasion. The disease is diagnosed quite rarely, and mainly in preschool children. The main symptom of the disease in question is that it forms single or multiple tumor foci that affect the tubular and flat bones. Most often, the vertebrae, femurs, bones of the cranial vault and pelvic bones are affected.

Malignant tumors include:

• This type of tumor is malignant, with it the bone skeleton is subject to damage, mainly the lower part of long tubular bones, the collarbone, spine, pelvis, ribs, and shoulder blade. Ewing's sarcoma ranks second in the frequency of diagnosis in children; in general, it occurs in children under 5 years of age, as well as in adults from 30 years of age. The main peak of incidence in this case is the age from 10 to 15 years. The causes of Ewing's sarcoma are currently still unknown, but 40% of cases of this disease have been associated with previous trauma. In rare cases, Ewing's sarcoma develops as an extraosseous pathology, which is accompanied by soft tissue damage, but, as already noted, bones are mainly affected. The disease can be localized and metastatic in developmental stages. The localized stage of Ewing's sarcoma determines for it the possibility of spreading from the primary lesion to soft tissues in close proximity to it, while distant metastasis is not observed. As for the metastatic stage, here the tumor can spread to other parts of the patient's body (bone marrow, bones, lungs, liver, central nervous system, etc.). In general, Ewing's sarcoma is the most aggressive of malignant tumor formations. Remarkably, in approximately 90% of cases when any therapy measures are started, metastasis is already actual for patients (the main areas are bones, lungs and bone marrow).
• Osteogenic sarcoma. Osteogenic sarcoma is a tumor whose malignant cells are formed at the expense of bone tissue, while they also produce this tissue. Osteogenic sarcoma can be sclerotic (osteoplastic), osteolytic, or mixed, which is determined radiographically. As is clear, such a sarcoma occurs directly due to bone elements, and it is also characterized by rapid progression and early metastasis. Osteogenic sarcoma is detected at any age, however, in approximately 65% ​​of cases, the peak incidence occurs between the ages of 10 and 30 years. It is also noted that basically the sarcoma develops by the end of puberty. As for sexual predisposition, it is also relevant here: men get sick almost twice as often as women. Long tubular bones are the predominant environment for localization of osteogenic sarcomas, and in about 1 out of 5 cases of osteogenic sarcomas, their localization falls on short or flat bones. Up to 6 times more often the bones of the lower extremities are affected in comparison with the bones of the upper extremities, while about 80% of the total number of tumors affecting the lower extremities are concentrated in the knee joint. The hip, humerus, tibia, fibula, pelvis, ulna, and shoulder girdle are also often affected. In the radius, where a giant cell tumor appears quite often, in rare cases it is accompanied by the growth of osteogenic sarcoma. Osteogenic sarcoma almost never grows from the patella. The skull is affected mainly in children, in addition, such a lesion is also relevant for elderly patients, but here it already acts as a complication of osteodystrophy. The development of the tumor in some cases is associated with the rapid growth of the bone. In children who are diagnosed with osteosarcoma, in most cases, growth is higher (if equal to the general age norm), while the disease itself affects those parts of the skeleton that grow the fastest. Basically, there is also a connection with trauma as a predisposing factor to the development of sarcoma, but trauma is more of a factor that allows it to be detected almost randomly during an X-ray examination.
• parosteal sarcoma. This type of sarcoma is one of the varieties of osteosarcoma. The frequency of its detection averages 4% of the total number of osteosarcomas, that is, the tumor is quite rare. It develops directly on the bone surface, its feature is a longer and, at the same time, less malignant course. A typical localization environment is the region of the knee joint (posterior surface of the femur or tibia), it accounts for about 70% of cases of this type of sarcoma. In rare cases, the skull, bones of the pelvis and spine, scapula, bones of the foot and hand are affected (literally isolated cases). This tumor has a bone consistency, it is concentrated outside the bone, however, it is associated with the underlying bone and with the periosteum. In frequent cases, it is, as it were, in a capsule, which, however, does not exclude the possibility of its germination into nearby muscles.
• Chondrosarcoma. This tumor is one of the most common tumor pathologies affecting the skeleton. It is based on cartilage. Basically, chondrosarcoma develops in flat bones, although it is also possible to detect such a tumor in tubular bones. There are several scenarios under which such tumors can progress. So, it can be a relatively favorable scenario of progression, in which the growth of the tumor formation is slowed down, and metastasis occurs at late stages, or an unfavorable one, in which tumor growth is rapid and metastasis begins early. These are two basic options for which certain deviations are possible when considering the overall picture of the disease in each case. Treatment of chondrosarcoma consists of surgical intervention, the prognosis is determined by the specific variant of the course of the disease, as well as the possibilities for a relatively radical effect on the tumor. Basically, the shoulder girdle, pelvic bones, femurs and humerus bones, and ribs suffer from this tumor. On average, in 60% of cases, the disease is diagnosed in patients of the middle and elderly age group (age from 40 to 60 years). Meanwhile, this does not exclude the possibility of detecting chondrosarcoma in patients of other ages. So, statistics indicate that the earliest case of this pathology was recorded at the age of 6, while the latest - at 90. Regarding gender predisposition, it can be noted that men are twice as likely to experience this disease compared to women. Chondrosarcoma can correspond to several degrees of malignancy of the process. So, 1 degree The malignancy of chondrosarcoma is accompanied by the predominant presence of chondroid tissue in the tumor, the latter, in turn, contains chondrocytes, which contain small dense nuclei. In a small amount, there are still multinucleated cells, there are no mitotic figures. For 2 degrees predominantly myxoid intercellular substance is characteristic, the number of cells is greater than within the 1st degree. The accumulation of cells occurs along the periphery of the lobules. The nuclei are enlarged, mitotic figures are present in a single amount, there are areas of destruction, that is, areas of necrosis. And finally 3 degree, it is characterized by the myxoid composition of the intercellular substance, the arrangement of cells in it occurs in strands or groups. The presence of stellate or irregularly shaped cells in a significant volume is determined. There are a lot of multinucleated cells, and a lot of cells with enlarged nuclei. There are mitotic figures, areas of necrosis are extensive. If we do not go into a detailed consideration of such changes, but start only from knowing the degree of chondrosarcoma, then we can indicate that the higher the degree, the higher the likelihood of early metastasis, as well as the development of a relapse of the disease after surgical removal of the tumor formation.
• Chordoma. This type of neoplasm can be referred to as both a benign tumor and a malignant tumor. Meanwhile, the benign nature of such a neoplasm is controversial. Given the fact that the growth of the tumor formation is slow, and metastasis is rarely observed outside of it, it is considered precisely as benign. However, due to the fact that the tumor is located in a specific area, it is its location that causes the development of complications. The tumor itself can subsequently recur, that is, resume its development after a seemingly complete recovery of the patient. It is for this reason, in accordance with the principles on which the international classification of neoplasms is based, that it is more correct to classify it as a malignant tumor. Chordoma is rarely diagnosed (in about 1% of cases of tumor formations affecting bone structures), it is formed on the basis of the remains of the embryonic chord. The chordoma of the sacrum is predominantly detected, in this case - in patients 40-60 years old, more often in men. If the tumor is diagnosed in young people, then it is usually a tumor at the base of the skull. It is these areas that are the main ones in the defeat of the chordoma. Tumors are divided into the following forms: chondroid chordoma, undifferentiated chordoma and normal chordoma. The chondroid chordoma is characterized by the least aggressiveness. The undifferentiated is prone to metastasis and is the most aggressive of these forms. Sometimes it is difficult to determine the specific type of tumor, in this case it is often believed that chondrosarcoma has formed (due to the common localization and structure). Here we are talking about an undifferentiated tumor, and, of course, the need to differentiate a specific neoplasm. If we are really talking about chondrosarcoma, and not about chordoma, then there are grounds for a favorable prognosis for it. The fact is that chondrosarcoma is more sensitive to treatment using radiation therapy, which is the basis for such statements. Treatment of chordoma requires surgical intervention, its volumes are determined individually, depending on the nature of the pathological process.

Bone Cancer: Risk Factors

Despite the fact that at the moment it has not been possible to determine the unambiguous cause of bone cancer, this does not exclude the identification of some factors that are predisposing to the development of this disease. In particular, these are:

• the presence of such a benign disease that affects the bones, such as Paget's disease;
• heredity (the presence of the closest blood relatives of this disease in the past);
• exposure;
• trauma to the bones (again, trauma cannot be considered as a factor contributing to the development of cancer, but it is with trauma, as already indicated, that the disease is detected).

Certain predisposing factors can be identified for some individual types of bone cancer.

• osteosarcoma: male, age from 10 to 30 years, bone marrow transplantation, retinoblastoma (eye cancer, a fairly rare disease), the presence of hereditary cancer syndromes.
• Chondrosarcoma: exostoses in a significant amount (a disease of a hereditary type, as a result of which the bones are affected by characteristic bumps), age from 20 years.

In other types of cancer, a sufficient factor for the development of cancer is compliance with a certain age group, which, meanwhile, cannot be unambiguously determined due to the variability of variants.

Bone cancer: symptoms

The clinical manifestation of the disease is based on the following symptoms:

• Pain. Pain, as you can understand, if it appears, then in the place where the tumor has formed. The pain can be constant, its intensification occurs during loads and movements, at night (the period of muscle relaxation).
• Puffiness. Puffiness similarly occurs in the area where the tumor is located, in particular, the swelling surrounds it. It is noticeable during the late stage of the course of the disease, that is, when the tumor has already reached a significant size. In some cases, edema may not be detected during examination and palpation.
• Difficulty of movements. Being in close proximity to the affected joint, the tumor, as it grows, leads to certain difficulties in its work. The movement of the limb because of this may be limited. If the joints of the legs have been affected, then this can cause numbness of the limbs, tingling in them, and lameness.
• Deformity of the affected limb or body.
• Weight loss, sweating, fever, lethargy are symptoms of a general “failure” of the body, both against the background of oncological diseases and against the background of diseases of any other type.

The listed symptoms, as you can see, are relevant for many diseases, and this applies not only to the last point. Meanwhile, if the duration of the manifestation of such a symptom as pain in the limbs is more than two weeks, it is necessary to consult a doctor for a comprehensive examination to identify a specific cause.

Cancer of the bones of the legs and pelvis

Quite rarely in practice there are primary tumors with damage to the bone tissue of the pelvic bones. With the same frequency in this case, osteosarcomas and chondrosarcomas are detected. Sarcoma of the hip joint is diagnosed even less frequently. Like many types of cancer, these pathologies are more often diagnosed in men (in comparison with women).

Let us dwell on the symptoms inherent in such a disease as cancer of the pelvic bones:

• Blunt pain, arising in the pelvis and buttock, in some cases, such pain may be accompanied by a short-term increase in overall body temperature.
• Increasing pain sensations noted in particular during physical exertion and while walking, the symptom is relevant with the gradual progression of tumor pathology.
• protrusion, swelling, also detected in the future, with the progression of the disease when the tumor acquires a significant size. The skin in the affected area becomes noticeably thinner, which makes it possible to notice the vascular pattern.
• Spreading the pain to the spine, perineum, groin, thigh, etc. This symptom is relevant for the later stages of the pathological process, when nerves and blood vessels are compressed by a tumor formation.
• Limited mobility of the affected joint.

The next part of the symptoms, on which we will dwell, corresponds to such a type of disease as leg cancer, its symptoms are diagnosed with the same frequency in both sexes, that is, in men and women.

• Pain in the legs, increased pain during exercise;
• Limited mobility of the affected limb;
• The appearance of edema on the skin, protrusions;
• Deformity of the affected limb;
• General symptoms of malaise (fever, lethargy, weight loss, weakness, etc.).

Also, regardless of the type of cancer, it is possible to designate such a symptom as bone fractures, which is more relevant for the later stages of cancer, when the tumor leads to significant damage to the joint to which it is directly related.

Diagnosis and treatment

Often, as we have already highlighted in the article, cancer is detected by chance, with no symptoms and during an X-ray examination, for example, for the presence of an injury. In the future, the doctor may prescribe a number of examinations, among them the following can be distinguished:

• a blood test (allows you to determine the level of actual alkaline enzyme phosphatase; if it is elevated, then there is reason to assume a bone tumor, which, however, is also relevant within the period of growth of a completely healthy child);
• x-ray examination;
• scanning of the bones of the skeleton (in this case, it means such a test with which you can determine where the tumor is located; for its implementation, a radioactive substance is introduced into the bloodstream, absorbed by the bone tissue, after which, using a special scanner, the features of its impact are monitored);
• CT, MRI;
• bone marrow biopsy.

As for such a question as cancer treatment, it is applied differently in each case of this disease, its principles are determined precisely on the basis of the variety, as well as on the basis of the stage of cancer, the area of ​​localization of the tumor formation, the patient's health status, the presence of metastases and other criteria. Basically, surgical removal of the tumor is indicated, although such methods of treatment as radiation therapy and chemotherapy can be used - basically in treatment they are an addition to surgery.

If you have symptoms that may indicate cancer, you should contact an orthopedist or an oncologist.

You can associate shoulder pain in the body with a physical injury. Shoulder pain can also be a symptom of lung cancer, and it may be the first symptom of this disease.

Lung cancer can cause shoulder pain in a variety of ways. Growth cancer in the upper half of the lung caused by a Pancoast tumor can pinch certain nerves that provide:

• shoulders
• shoulders
• spine
• head

This can cause a cluster of symptoms like Horner's syndrome. Symptoms of Horner's syndrome include:

• severe shoulder pain, which is one of the most common symptoms
• weakness in one century
• decrease in pupil size in one eye
• decreased sweating on the affected side of the face

Shoulder pain can also be caused by a tumor in the lung that has spread to the bones in and around the shoulder or spine. If the swelling in the lungs is large, it can press on other nearby structures and contribute to shoulder pain. This is called a mass effect.

Some pain in the shoulder occurs when the tumor puts pressure on the french nerve in the lungs. The brain interprets this from the shoulder, even though the nerve is in the lungs. It's called "pain called pain". "

Shoulder pain from lung cancer is very similar to other forms of shoulder pain. It can be difficult to determine the cause of shoulder pain. If you have recently fallen or injured your shoulder, lung cancer is unlikely to cause shoulder pain. Lung cancer may be causing your pain, especially if you are a smoker and your pain:

• happens during rest
• not associated with any strenuous activity involving the shoulder
• , takes place at night
• does not resolve itself after a few weeks

Lung cancer often causes chest pain. Sometimes this chest pain is the result of a strong and prolonged cough. In other cases, lung cancer pain is the result of a large tumor pressing on other structures or growing into the chest wall and ribs. Tumors in the lungs can also press on blood vessels and lymph nodes. This causes fluid to build up in the lining of the lung and this can cause pain or shortness of breath.

Symptoms Other symptoms of lung cancer

The symptoms of lung cancer are difficult to determine. Sometimes it can take months or even years for symptoms to show.

Many symptoms of lung cancer occur in the chest. These include:

• shortness of breath or shortness of breath
• harsh sound with each breath or stridor
• persistent, intense cough
• chronic lung diseases, including pneumonia and bronchitis
• coughing up blood, phlegm or mucus
• chest or back pain
• changes in the voice, such as hoarseness
• change in color or volume of sputum, which is a mixture of saliva and mucus

Discomfort in the lungs and chest area can also occur due to respiratory conditions such as bronchitis and emphysema.

In later stages of lung cancer, the original cancer may spread to other parts of the body. These include:

• liver
• bones
• The lymph nodes
• nervous system
• adrenal glands

Other symptoms of lung cancer include:

• fatigue
• exhaustion
• muscle loss or cachexia
• blood clots
• excess bleeding
• swelling of the face and neck
• bone fractures
• headache
• pain in bones and joints
• Other reasons. What else causes shoulder pain?
• If you have shoulder pain, chances are you don't have lung cancer. Various health conditions cause shoulder pain, including:

minor injury

poor posture when sitting or standing

• frozen shoulder
• broken arm broken collarbone
• rotator cuff disorders
• tendinitis
• osteoarthritis
• dislocated shoulder
• problems with the acromioclavicular joint
• bursitis
• overactive thyroid or hyperthyroidism
• What causes shoulder pain? 32 possible states"
• Shoulder Examination How does your doctor know about shoulder pain?

If you're experiencing shoulder pain, your doctor will likely do a shoulder exam to help determine the source of your pain. review your other symptoms to put your test results in context and better understand the whole picture.

Diagnosis How to diagnose lung cancer?

Your doctor will first review your symptoms. Then, if they think lung cancer might be a possibility, they will use a screening procedure such as a CT scan or positron emission tomography to get an internal image of your lungs. This gives a clearer picture of any potentially cancerous tumors.

If they still suspect lung cancer after your screening, they may ask for a small piece of lung tissue to be examined close to the cancer cells. This is called a biopsy.

Doctors can perform lung biopsies in two ways: they can pass a needle through the skin into the lungs and remove a small amount of tissue. This is called a needle biopsy. Alternatively, your doctors may use a bronchoscopy to take a biopsy. In this case, your doctor inserts a small tube with a light attached through your nose or mouth and into your lungs to remove a small sample of tissue.

If they find cancer cells, your doctor may run a genetic test. This can help your doctor determine what type of lung cancer you have and possibly identify underlying causes such as genetic mutations. It also helps the most effective treatment.

TreatmentWhat are the common treatments for lung cancer?

If you have lung cancer, your doctor may use a variety of treatments, including:

surgery

chemotherapy

• radiation
• targeted drugs
• immunotherapy
• Doctors will often use more than one lung cancer treatment. For example, they may prescribe chemotherapy or radiation to shrink the tumor before surgery. They may also try another method if another doesn't work. Some of these treatments have side effects. You can manage side effects with proper planning and education.
• Coping with pain What can you do to manage shoulder pain?

You can manage shoulder pain if you deal with its underlying cause. If your doctor diagnoses you with lung cancer, it's important to get the best treatment.

If your shoulder pain isn't related to lung cancer, it's important to determine the cause. This will help your doctor develop a treatment plan. For example, they may recommend physical therapy if you have shoulder pain due to tendinitis. If you have shoulder pain due to diabetes, your doctor may recommend a combination of glucose-lowering medications and a low-carbohydrate diet.

You can try home treatments while you wait for your doctor:

Avoid using an injured shoulder.

Try to wrap around your shoulder for 15-20 minutes at a time. This can help reduce pain and swelling.

• Try wrapping your shoulder with an elastic band. Using compression can help you avoid overusing your shoulder.
• Raise your shoulder above your heart as much as possible. You can use pillows to help you with this.
• Outlook
• Most forms of shoulder pain are not symptoms of lung cancer. Other possible causes include tendinitis, diabetes, and poor posture. However, shoulder pain is an often underestimated symptom of lung cancer. If you are experiencing shoulder pain and have other symptoms of lung cancer or are at high risk for it, do not delay seeing your doctor. Early diagnosis is the key to effective lung cancer treatment.

Shoulder cancer - This is a malignant lesion of inert and cartilaginous tissues located in the shoulder region. The development of a tumor can be an independent process or a metastasis of a neoplasm in another part of the body. Primary involvement of the humerus (clavicles and scapula) is extremely rare. Most bone tumors are localized near the joints and are predominantly seen in young people (25-35).

Classification of cancerous lesions of the shoulder region

• : osteoblastoma, osteosarcoma.
• Cartilaginous neoplasms: chondrosarcoma, chondroblastoma.
• Malignant lesions of fibrous tissue: fibrosarcoma, histiocytoma.

Causes of Shoulder Cancer

The reliable cause of the cancerous transformation of healthy tissues of the shoulder area of ​​the body is currently unknown. Oncologists distinguish the following risk factors:

• genetic predisposition.
• Exposure to harmful chemicals.
• consequences of radiation therapy.
• Chronic injuries of the upper shoulder girdle.

Symptoms of shoulder cancer

The patient may suspect the presence of a malignant neoplasm by the general signs of an oncological lesion:

• General weakness.
• Subfebrile body temperature.
• Sudden loss of body weight and appetite.

The most common symptom of shoulder cancer is pain. At the initial stage of the disease, pain sensations are unexpressed and can disappear spontaneously. In the process of developing an oncological disease, the intensity of the pain syndrome increases, which is not removed with the help of traditional painkillers.

Among the local manifestations of a shoulder tumor, the second most important is the formation of persistent edema in the affected area. The volume of swollen tissues directly depends on the prevalence of pathology.

In the later stages of the disease, many patients experience frequent bone fractures even after minor bruises or slaughter. Deformations of the inert structure are explained by the increased fragility of the damaged tissue.

In some cases, the above symptoms are accompanied by impaired motor function of the upper limb on the side of the oncological process.

Shoulder cancer diagnosis

The definition of the type begins with a visit to the oncologist, who conducts a visual and palpatory examination of the patient. During the consultation, the doctor finds out the history of the disease and the presence of complaints in the patient. To determine the nature of the tumor and its location, oncologists use additional diagnostic methods, which include:

• Laboratory blood test using oncology markers.
• Scanning of bone tissue, which is carried out using radioactive substances.
• Computed and magnetic resonance imaging. These research methods allow you to determine the exact location of the tumor and its tissue structure.
• X-ray examination.

The final diagnosis of the malignant process of the shoulder region is possible after a biopsy, which consists in the surgical removal of a portion of the affected tissue for cytological and histological analyzes. As a result of a laboratory study of biological material, a specialist establishes the stage of the cancer process and its prevalence.

Shoulder Cancer Treatments

Depending on the type of malignant tumor and the localization of the malignant lesion, the oncologist may use the following methods of treatment:

1. Surgery

Surgical treatment of shoulder oncology includes the removal of a malignant neoplasm, part of adjacent healthy tissue, and regional lymph nodes. additionally provides for a reconstructive operation with the use of prosthetics of the lost area of ​​bone tissue. If possible, the surgeon during the excision of the tumor uses a sparing operating technique, which consists in the maximum possible preservation of healthy tissues around the oncological lesion.

1. Radiation therapy

The impact of high-frequency X-ray radiation on the region of the upper shoulder girdle leads to the death of cancer cells, which helps to reduce the volume of the tumor and stabilize the pathological process. The method is shown as an independent method of treatment and as a preparatory stage before the surgical removal of oncology.

1. Chemotherapy

This technique is mainly used in the complex therapy of shoulder pathology. The essence of chemotherapy is the use of cytotoxic drugs for the destruction of a malignant neoplasm. Chemotherapeutic agents are available in the form of tablets and ampoules for intramuscular or intravenous infusion.

1. High-intensity therapy, including the introduction of stem cells

The method is recommended for patients in the late stages of the disease with the formation of metastatic foci in the bone marrow. When using this technique, the patient is exposed to chemotherapy drugs and the replacement of the affected intraosseous tissue with stem cells.

Forecast

The long-term prognosis of a malignant tumor of the shoulder tissues is positive, provided that the pathology is detected early and treated in a timely manner. In the later stages of the disease with the formation of metastases, the consequences of the disease are considered unfavorable for life.

With a malignant lesion of cartilage and bone tissues in the shoulder area, cancer of the shoulder joint is diagnosed. This process may be primary, but more often this pathology is observed with metastases of a tumor located somewhere else. A provoking factor in the development of such a tumor can be a genetic predisposition, radiation treatment, and even chronic joint injury.

Types of shoulder cancer

There are several types of shoulder cancer. They are classified according to the tissues affected by the disease. A malignant process can capture bone tissue, cartilage or fibrous.

Classification of malignant tumors of the shoulder:

• Osteoblastoma, osteosarcoma with bone lesions,
• Chondrosarcoma, chondroblastoma with cartilage damage,
• Fibrosarcoma, histiocytoma with localization of the process in fibrous tissue.

How is it manifested?

At the initial stage of the disease, especially with primary tumors, symptoms may be completely absent or appear very slightly and resemble manifestations of other joint diseases.

The most common symptom of shoulder cancer is pain in the shoulder area. Initially, the pain is weak, may appear and disappear for no apparent reason. With the development of the oncological process, the pain becomes stronger and gradually the usual painkillers stop working. Another characteristic symptom is swelling of the affected tissues. The size of the edema depends on the size of the tumor.

Symptoms in the early stages:

In later stages, the first symptoms intensify. When the process is localized in the bones, the bone tissue is damaged. This causes frequent fractures, which can occur even with minor blows or bruises. In addition, cancer of the shoulder joint may be accompanied by impaired motor function. In later stages, the oncological process affects the entire body. The person feels worse than usual, weakens.

Symptoms in the later stages:

• Increased bone fragility
• joint deformity,
• motor dysfunction,
• general weakness,
• Weight loss,
• Subfebrile temperature.

Fever, weakness, loss of appetite and weight are symptoms common to all cancers. They appear in the third or fourth stages, when the body is weakened as a result of the vital activity of the tumor and metastases.

Diagnosis and treatment

The diagnostic process begins most often at an appointment with a general practitioner or surgeon, who, suspecting the presence of a tumor in a patient, refer him to an oncologist. Diagnosis is carried out with the help of visual and palpation examination of the patient and the performance of hardware and laboratory tests.

Diagnostic procedures:

Based on the results of one study, it is impossible to make a final diagnosis, so a comprehensive examination is always necessary. As a rule, the final answer is given by a biopsy, since the results of the study of tissues show the nature of the tumor cells. In the presence of atypical cells, a malignant tumor is diagnosed.

In general, the diagnosis provides answers to questions about the location, size of the tumor, the stage of its development, the presence of metastases.

For treatment, traditional methods for oncological processes are used:

• surgery,
• radiation therapy,
• chemotherapy.

In recent years, stem cell therapy has become more and more widespread. They replace the affected and dead cells of the affected tissues.

The result of treatment directly depends on the stage of the disease. If treated early, the prognosis is often good, especially for primary tumors. It is possible to suspend the process, reduce the tumor or completely get rid of it. In the later stages, rather intensive treatment is necessary, which is associated with side effects. However, modern medical science creates more and more new drugs and treatments that are more effective and less dangerous.