The functional and clinical outcomes of primary and metastatic malignancies of the elbow
Güray Toğral1
, Hüseyin Emre Tepedelenlioğlu2, Erkan Akgün2, İzzet Korkmaz1, Tolga Tolunay3
1Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Türkiye
2Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara, Türkiye
3Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Türkiye
Keywords: Elbow, limb-sparing surgery, malignant bone tumors, soft tissue sarcoma, wide resection.
Abstract
Objectives: This study aims to investigate the etiological distribution of primary and metastatic malignancies around the elbow and the effect of surgical and adjuvant treatments on clinical outcome.
Patients and methods: Between January 2006 and December 2020, medical records of a total of 33 patients with elbow neoplasm (15 males, 18 females; median age: 55 years; range, 39 to 71 years) who underwent surgical treatment and with or without clinical treatment were retrospectively analyzed. The outcomes and frequencies of the elbow metastatic and primary malignancies were evaluated. Data were collected from patients' medical and radiological documents, and a dedicated archive was created for this study.
Results: Most tumors occurred on the right side and were intra-articular or distal to the humerus. A total of 75.8% (25/33) of the patients had tumors of any diameter ≥5 cm. Most patients were treated with extensive resection. A total of 81.8% (27/33) of the patients had wide resected tumor margins, and 18.2% (6/33) had intralesional tumor margins. The median follow-up was 42 (range, 1 to 83) months. Synovial sarcoma and malignant peripheral nerve sheath tumors were the most common soft tissue sarcomas, and pulmonary adenoma and multiple myeloma were found in metastatic lesions.
Conclusion: Elbow surgery is particularly challenging due to the interrelationship of major neurovascular structures. Synovial sarcoma and malignant peripheral nerve sheath tumors are the most common soft tissue sarcomas, and pulmonary adenoma and multiple myeloma are found in metastatic lesions. Limb-sparing surgery is the gold-standard method recently.
Citation: Toğral G, Tepedelenlioğlu HE, Akgün E, Korkmaz İ, Tolunay T. The functional and clinical outcomes of primary and metastatic malignancies of the elbow. Jt Dis Relat Surg 2024;35(3):628-636. doi: 10.52312/jdrs.2024.1738.
The study protocol was approved by the Gazi University Ethics Committee (date: 05.10.2023, no: E-77082166-604.01.02-764631). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Idea/concept: G.T.; Design: G.T., H.E.T.; Control/supervision: T.T.; Data collection and/or processing, writing the article: H.E.T.; Analysis and/or interpretation: İ.K.; Literature review, critical review: G.T., T.T.; Materials: E.A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.