Preoperative embolization of a solitary bone plasmacytoma of the proximal humerus

TL;DR

A 70-year-old woman with a rare bone tumor in her shoulder underwent preoperative embolization to reduce blood loss during surgery, successfully preserving her shoulder function.

Contribution

This case highlights the potential efficacy of preoperative embolization for hypervascular bone tumors, particularly in rare plasma cell malignancies.

Findings

Preoperative embolization reduced blood loss to 100cc during surgery for a solitary plasmacytoma of the proximal humerus.

The patient regained full shoulder range of motion and baseline function six months post-surgery.

The case supports considering embolization as an adjunctive therapy for hypervascular bone tumors regardless of origin.

Abstract

Solitary plasmacytoma of bone (SPB) is a rare plasma cell malignancy that most often presents with localized pain. This case describes a 70-year-old female with a pathologic humeral fracture due to a large, hypervascular SPB. The tumor was assumed to be a metastatic lesion, and preoperative embolization was performed to minimize intraoperative blood loss, followed by tumor debulking and total shoulder arthroplasty. The total estimated blood loss was limited to 100cc, and the patient was returned to baseline functional status with full shoulder range of motion at 6 months postop. Literature on embolization of appendicular plasmacytomas is sparse; however, this case supports its efficacy. We recommend considering preoperative embolization as an adjunctive therapy for all hypervascular bone tumors requiring surgical management, regardless of origin.

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