Metastases from renal cell carcinoma to the humerus or the shoulder girdle

Abstract
To discuss the clinical presentation of metastases in the scapula and/or humerus resulting from renal cell carcinoma and the courses of treatment available. A series of 35 patients with humeral or scapular metastases from renal cell carcinoma, treated at The Norwegian Radium Hospital (NRH) during an 11-year period, is reviewed. Two case reports are examined in detail. The median survival was 12 months (range 1-88) from the time of diagnosis of metastasis. Three patients lived for more than 50 months. Owing to the relatively long survival time, especially in patients with limited tumour burden elsewhere and who are in a good general state of health, long-lasting palliative treatment of the humeral or scapular metastases is aimed for. Renal cell carcinoma tends to be resistant to radiotherapy, and early treatment, combining orthopaedic surgery and high-dose radiotherapy, is advocated.