Pediatric shoulder girdle tumors: Long-term oncologic and early functional outcomes

The shoulder girdle is a common location for both benign and malignant bone tumors in children, with the proximal humerus being the most frequently affected site. However, comprehensive outcome data for surgically treated pediatric shoulder girdle tumors are limited. This study aimed to evaluate the pathological diagnoses, anatomical locations, surgical treatments, and midterm functional outcomes of shoulder girdle tumors managed surgically in childhood and adolescence.

A retrospective analysis was conducted on 69 pediatric patients (mean age: 11.9 years) who underwent surgical treatment for shoulder girdle tumors between 2012 and 2019, a window selected to ensure a minimum oncologic follow-up of ≥5 years at the time of analysis. Data on demographics, tumor type and location, surgical method, complications, recurrence, and functional outcomes using the Musculoskeletal Tumor Society score and Toronto Extremity Salvage Score were analyzed.

The most common benign tumor was a simple bone cyst (43.5%), followed by osteochondroma (20.3%) and aneurysmal bone cyst (8.7%). Osteosarcoma (5.8%) was the most frequent malignant tumor. The proximal humerus was affected in 92% of cases. Limb-sparing surgery was preferred in malignant tumors when feasible. The mean Musculoskeletal Tumor Society score and Toronto Extremity Salvage Score in patients with malignant tumors were 64 ± 19 and 66 ± 21, respectively. Recurrence was observed in 1 patient with a simple bone cyst and 1 with Ewing sarcoma. Functional outcomes were satisfactory, particularly in patients with benign tumors.

Most pediatric shoulder girdle tumors are benign and can be effectively managed with appropriate surgical interventions. Favorable functional outcomes are achievable even in malignant cases when limb-sparing strategies are employed. Long-term follow-up is essential to monitor for recurrence and complications.