Clinicopathological Study and Management of Primary Malignant Scapular Tumors; 10 Years National Cancer Institute Experience

Abstract

Introduction: Primary malignant scapular tumors are very rare. Little is written about flat bone sarcomas in the literature, and not much is known about the oncological outcome. Objective: The aim of the current work is reviewing clinicopathological features and surgical management of cases with primary malignant scapular tumors. Patients and methods: Patients with primary malignant scapular tumours who visited the National Cancer Institute (NCI) at Cairo University, Egypt, between January 2009 and December 2019 were subjected to a retrospective descriptive analysis. Results:The study included 25 patients with a mean age of 33.4 years old ranging from 9 to 86 years. Pathology types were chondrosarcoma in 14 patients (56%), Ewing/PNET in 7 patients (28%), osteosarcoma in 2 patients (8%), spindle cell sarcoma in 1 patient (4%), and aneurysmal bone cyst in 1 patient (4%). Twenty patients (80%) had surgery, and 5 patients (20%) had no surgical intervention for being either with a poor general condition or having metastatic disease. Overall survival at 6 months was 92% and was 88%, 75.4%, and 65.4% in the first year, 3 rd year, and 5 th year respectively. Disease-free survival at 6 months was 90.5%; and was 85.7%, 75.4%, and 42.7% in the first year, 3rd year, and 5th year respectively. Conclusion: Primary malignant scapular tumors are rare. Early diagnosis is very important, as surgical excision with a wide negative margin (limb-sparing surgery) is the main line of treatment in most cases and tends to decrease the recurrence rate, otherwise, palliative treatment and forequarter amputation may be indicated.