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A smoker with a painful kidney and a shoulder tumor

Submitted by henry on Mon, 08/02/2010 - 11:53
Case Identification
Case ID Number: 
20100802SM
Periosteal Reaction: 
absent
Benign/Malignant: 
Malignant
Clinical case information
Case presentation: 

The patient is 59, and she has a 40 pack years smoking history. Seven years ago, she had a painful kidney removed, and a tumor was found in the kidney.

On examination, the left upper extremity is in a sling. The patient cannot really move the arm outside of the sling. No mass is felt around the shoulder at all, and there is no swelling of the affected bone.

Radiological findings:: 
Plain radiographs show an aggressive destructive mass occupying the proximal humerus with pathological fracture. There is a somewhat permeated appearance of the shaft of the humerus below the lesion.
Differential Diagnosis: 
The patient has a bone lesion in the left proximal humerus which will require biopsy and stabilization of pathological fracture. Possibilities include renal cell carcinoma, lung carcinoma, myeloma or lymphoma, and other.
Image Reference: 
A smoker with a painful kidney and a shoulder tumor
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