Keywords:
Pathology, Metastases, Cancer, Education, Ultrasound, MR, CT, Musculoskeletal system, Musculoskeletal bone, Anatomy
Authors:
K. Paramesparan1, A. Shah1, A. M. Davies2, S. L. James2, R. Botchu2; 1Leicester/UK, 2Birmingham/UK
DOI:
10.1594/essr2017/P-0319
Background
The acromion is an anteriorly projecting process arising from the lateral end of the spine of the scapula and supports the insertion of the deltoid muscle on the lateral and posterior aspects of the coraco-acromial ligament anteriorly.
It forms a synovial joint with the lateral end of the clavicle.
The acromion process itself has four ossification centers (pre-acromion (PRE),
meso-acromion (MESO),
meta-acromion (META) and basi-acromion (BASI) and in most cases full fusion will occur by the age of 18.
Malignant and benign acromial tumours are rare.
The acromion process is a rare site for tumour formation and it is therefore often failed to be included in the differential diagnosis of shoulder pain. Given the rarity of presentations we provide a review of the tumours with emphasis on the principal radiological features.
We discuss benign and malignant pathologies and radiological findings from the tumours presented to our Orthopaedic oncology center.
A retrospective review of an oncology database from a UK Tertiary Orthopedic oncology Centre revealed 32 cases of acromion lesions.
Each case was evaluated for its demographics,
diagnosis and location on the acromion (PRE,
MESO,
META,
BASI).
There were 20 females and 12 males with the average age of 53-years (ages ranging from 12 to 84 years).
Benign and malignant pathologies were noted with chrondrosarcoma being the most common malignant tumours of the acromion process.
Other malignant lesions included metastasis,
lymphoma,
myeloma and osteosarcoma.
Benign lesions
Diagnosis
|
n.
|
%
|
CHONDROSARCOMA
|
7
|
21.9
|
MET
|
7
|
21.9
|
MYELOMA
|
6
|
18.8
|
BENIGN
|
3
|
9.4
|
LYMPHOMA
|
3
|
9.4
|
CHONDROBLASTOMA
|
2
|
6.3
|
INFECTION
|
2
|
6.3
|
OSTEOCHONDROMA
|
2
|
6.3
|
|
|
|
The majority of tumours of the acromion process were malignant or as a result of metastasis.
From our review we identified 23 malignant bone tumours (77%).