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A smoker with elbow pain

Submitted by henry on Tue, 07/21/2009 - 22:20
Case Identification
Case ID Number: 
20090721AS
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

This 67 year old male presentat with pain and a mass in the right dominant elbow. He had a history of smoking for many years. Work-up revealed a lytic lesion in the distal humerus.

Radiological findings:: 
An aggressive lytic destructive lesion has destruyed most of the humerus just above the elbow. No matrix is seen and no periosteal reaction is evident. A bone scan shows the lesion, but no other abnormal areas. An MRI shows the lesion has expanded aggressively into the soft tissues.
Treatment Options:: 
This lesion could be a primary sarcoma, if so what type is most likely? What would you do? This lesions might also be a metastatic tumor - if so what is the most likely source? What should be done in that case?
Image Reference: 
A smoker with elbow pain
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