• Petko Ganev Medical University, Plovdiv, Bulgaria
  • Vladimir Stavrev Medical University, Plovdiv, Bulgaria
  • Luben Stokov UMHAT “Sv. Ana”, Sofia, Bulgaria


Tumor, Humerus, Enormous


With this report we aim to present two cases of patients with malignant neoplasms in the region of the proximal humerus. The patients were both operated with their limbs spared.
The two patients described in this report are very recent cases. The first one, a 60 y.o. man was admitted to the hospital in May 2021. He had a large tumor in the proximal humerus that developed very fast (in a matter of 3 months), getting huge in size. The Shoulder joint became less and less mobile and eventually almost no motion was possible. He was operated with his proximal humerus replaced with a reverse tumor prosthesis “Arrow”.
The second patient, a 78 y.o. female was admitted to the hospital in September 2021. She developed a large formation seemingly in the midshaft area of the humerus. The process took less than a year. The initial X-ray images and clinics were strongly suggesting osteosarcoma, however the MRI made us perform extirpation of the formation. The tumor was removed entirely and what seemed like a osteosarcoma came out to be a degenerated Exostosis cartilaginea.
Although the first patient had almost his entire Deltoid muscle consumed by the formation he is slowly regaining range of motions. He is undergoing physiotherapy and his treatment is still being planned because the tumor came out to be a metastatic one.The female patient had no injury of the main anatomical elements (particularly n. Radialis due to the close proximity of the formation) and is even now regaining full range of motions. She is being planned for radiotherapy and is still recovering in the hospital.
Although the cases of enormous tumores are relatively rare their treatment stand a great challenge for the surgeon. With the treatment we chose and more specifically the limb salvage operations we believe that the patient will still have a good life expectancy but the high level of quality of life compared with amputees for example is a huge advantage.


Barani M, Mukhtar M, Rahdar A, Sargazi S, Pandey S, & Kang M. (2021). Recent Advances in Nanotechnology-Based Diagnosis and Treatments of Human Osteosarcoma. Biosensors (Basel). 2021 Feb; 11(2): 55.

DÁrienzo A, Ipponi E, Ruinato A, Franco S, Colangeli S, Andreani L, & Capanna R (2021). Proximal Humerus Reconstruction after Tumor Resection: An Overview of Surgical Management; Hindawi jou, vol. 2021

Gamuer G, Weinberg D, Collier Ch, Getty P, & Liu R; (2017). An Osteological Study on the Prevalence of Osteochondromas; Iowa Orthop J. 2017; 37: 147–150.

Harrison Ch, Spencer R, & Shackley D (2019). Transforming cancer outcomes in England: earlier and faster diagnoses, pathways to success, and empowering alliances. J Healthc Leadersh. 2019; 11: 1–11

Imai R, Kamada T, & Araki N (2017). Clinical Efficacy of Carbon Ion Radiotherapy for Unresectable Chondrosarcomas; Anticancer Res. 2017 Dec

Kawaguchi S, Weiss I, Lin P, Huh W, & Lewis V; (2014). Radiation Therapy Is Associated With Fewer Recurrences in Mesenchymal Chondrosarcoma); Clin Orthop Relat Res. 2014 Mar; 472(3): 856–864

Owens Ch, Sperling J, & Cofield R (2012). Utility and complications of long-stem humeral components in revision shoulder arthroplasty; J Shoulder Elbow Surg. 2013 Jul;22(7):e7-12

Park H, Lee S, & Chang Y (2020). Recent advances in diagnostic technologies in lung cancer. Korean J Intern Med. 2020 Mar; 35(2): 257–268

Papandrianos N, Papageorgiuo E, Anagnostis A, & Papageorgiou K (2020). Efficient Bone Metastasis Diagnosis in Bone Scintigraphy Using a Fast Convolutional Neural Network Architecture, Diagnostics (Basel). 2020 Aug; 10(8): 532

Tepelinis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, Kanavaros P, & Kitsoulis P (2021). Osteochondromas: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features and Treatment Options; In Vivo. 2021 Mar-Apr; 35(2): 681–691

Torti J, & Correa R (2021). Adrenal Cancer; Stat Pearls Publishing; 2021 Jan




How to Cite

Ganev, P., Stavrev, V., & Stokov, L. (2022). TWO CASES OF ENORMOUS TUMORS IN THE PROXIMAL HUMERAL REGION. KNOWLEDGE - International Journal, 48(3), 421–427. Retrieved from