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Biopsy of lesion
95%
2113/2230
Total elbow arthroplasty
1%
15/2230
Currettage and bone grafting
3%
71/2230
Percutaneous cement injection
0%
5/2230
Radiofrequency ablation
8/2230
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The radiograph demonstrates a solitary lesion of the supracondylar lesion of the humerus in a patient with history of localized breast cancer. Work-up shows this to be an isolated lesion. Biopsy must be performed to rule out primary bone malignancy before definitive treatment is performed. Rougraff discuss the indications for operative treatment in patients with metastatic carcinoma. They argue the decision whether to perform prophylactic surgery depends on: 1) the biologic activity of the bone lesion; 2) the responsiveness of the bone lesion to medical and radiation therapy; 3) the anatomic location of the bone metastasis; 4) patient factors, such as overall health status, expected length of survival, compliance, and patient expectations and needs. They explore these 4 issues in detail and recommend a clinical approach to patients with skeletal metastases.
4.3
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