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Endoprosthetic elbow replacement in patients with solitary metastasis resulting from renal cell carcinoma
1Department of Orthopaedics, University of Würzburg, König-Ludwig-Haus, Germany.
Abstract:
Renal cell carcinoma is one of the most common cancers, and solitary metastasis to bone occurs in 2.5% of these patients. Localization of solitary metastasis to the elbow joint is rarer still, and data about these patients are limited. Because, in these cases, metastasis presents with osteolytic bone destruction, radical removal of solitary lesions should be considered. The aim of this treatment is to control the tumor locally, to reduce pain, and to restore function. We describe 4 patients with a solitary metastasis to the elbow from renal cell carcinoma who had the tumor resected and were then fitted with a custom-made elbow prosthesis. After surgical reconstruction, all patients reported markedly reduced pain and had a good functional outcome. The literature and our experience indicate that the prognosis for patients with just a solitary metastasis is sufficiently encouraging to warrant the use of all surgical and oncologic treatment options, especially if the interval between the diagnosis of the primary tumor and the development of the metastasis is lengthy.
Insights
Solitary bone metastasis from renal cell carcinoma to the elbow is rare. Surgical resection with custom prostheses effectively reduced pain and restored function in four patients.
Area of Science:
- Oncology
- Orthopedic Surgery
- Bone Metastasis
Background:
- Renal cell carcinoma (RCC) is a common cancer.
- Solitary bone metastasis occurs in 2.5% of RCC patients.
- Elbow joint metastasis from RCC is exceptionally rare, with limited available data.
Purpose of the Study:
- To evaluate the efficacy of radical resection and custom-made elbow prosthesis in patients with solitary elbow metastasis from RCC.
- To assess pain reduction and functional outcomes post-surgery.
- To review the literature and present our experience with this rare presentation.
Main Methods:
- Case series of 4 patients with solitary elbow metastasis from RCC.
- Surgical resection of the solitary metastatic lesion.
- Reconstruction using custom-made elbow prostheses.
- Assessment of pain and functional outcomes post-operatively.
Main Results:
- All 4 patients experienced significant pain reduction after surgical reconstruction.
- Good functional outcomes were reported by all patients post-surgery.
- The treatment successfully controlled the tumor locally and restored elbow function.
Conclusions:
- Radical resection of solitary osteolytic bone metastases from RCC to the elbow, followed by custom prosthesis reconstruction, is a viable treatment option.
- This approach can effectively manage local tumor control, alleviate pain, and restore function.
- A lengthy interval between primary RCC diagnosis and metastasis development may indicate a favorable prognosis, supporting aggressive treatment strategies.
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