Non-Hodgkin’s lymphoma: unexpected cause of shoulder pain. A systematic review of the literature

Caporale, Manlio Fabio and Gambino, Giovanni Francesco and Larosa, Fabio Saverio and Del Buono, Angelo and Di Segni, Federico (2013) Non-Hodgkin’s lymphoma: unexpected cause of shoulder pain. A systematic review of the literature. M.L.T.J. Muscles, Ligaments and Tendons Journal, 3 (3). pp. 236-239. ISSN 2240-4554

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Abstract

The non-Hodgkin lymphoma (NHL) is one of the most common shoulder neoplasms, especially the diffuse large B cell lymphoma (DLBCL). We report a rare case of shoulder pain in a 80-yearold man presenting with a six-month history of continuous severe pain to the right shoulder. Routine laboratory studies were normal. Shoulder MRI showed an in-growing inhomogeneous lesion in the anteromedial aspect of the right humeral head extended within the cortical bone of the humerus (osteolitic lesion), next to the surrounding soft tissues. He also underwent shoulder arthroscopy: the intra-articular involvement of the shoulder was therefore excluded. A percutaneous bone biopsy performed on the same day was diagnostic for lymphoma. Three days later, the patient underwent surgical excision of the mass; a reverse shoulder prosthesis was then implanted (Aequalis reversed prosthesis). The patient started chemiotherapy according with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen, but did not tolerate it because of the sudden onset of herpes zoster. At 9- month follow-up, the patient is doing well, with fair range of motion, due to the delay of rehabilitation, but no shoulder pain and no evidence of local or systemic recurrence. A painful shoulder may be due to lymphoma even in the absence of classical symptoms. In suspected patients, plain radiographs should be followed by magnetic resonance imaging and bone biopsy. Tumor removal and shoulder arthroplasty can be an effective therapy. Given the devastating side effects of adjuvant chemotherapy, we do not recommend it in elderly patients

Item Type:	Article
Uncontrolled Keywords:	Shoulder pain; non-Hodgkin lymphoma
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.7 Malattie del sistema muscoloscheletrico
Depositing User:	Danilo Dezzi
Date Deposited:	17 Apr 2014 15:40
Last Modified:	17 Apr 2014 15:40
URI:	http://eprints.bice.rm.cnr.it/id/eprint/8335

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