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Can Dark Spot At The Center Of Humerus Ball Be An Inciation Of Cancer?
Question: Hello, my father is 80 yr of age. 2 wk ago he fell over some bricks. He had x-rays of his shoulder. There was a break noted, but also a dark spot was seen in the center of ball of the humerus. I thought it may be a cyst, but the ortho Dr seem bit concern. NM and MRI is scheduled. He really doesn't have any symptoms like I have been reading up on, just normal body ache. His potassium level is just a couple of point over normal. Can this all be pointing to Cancer?
Brief Answer:
Always a possibility, tests will be useful
Detailed Answer:
Dear son,
Thanks for your query. Bone abnormalities in the elderly could either mean benign disease such as a bone cyst, or malignancy, most commonly from metastatic disease. It is quite tough to make a firm conclusion over a plain x-ray, so the other upcoming tests will be great to make a more informed call. The nuclear medicine test will be looking for a "hot spot", tumors metabolize sugar quickly and appear as hot spots in the camera, if there is no increased uptake in that area of the dark spot, then concerns are less for malignancy. Thet being said, caveat, with a local fracture there can be local inflammation of the area which may increase uptake.
Now, an MRI is going to be done, great, because it will delineate the anatomy of the structure, see if it is weel defined, encapsulated, smooth, etc, all which are consistent with benign disease, rather than irregular, spiculated, highly vascular etc.
Hope that helps, wish you both the best,
Dr Brenes-Salazar MD
Mayo Clinic MN
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your input with such little information. I do have one more question. Now if it is a malignancy from a metastatic disease. I heard certain cancers metastasis to certain aeras. So if this can be a bone malignancy, where is it or could be the most likely the primary cancer site ?
Brief Answer:
Prostate and lungs
Detailed Answer:
In men, 80% of metastatic disease is due to prostate or lung cancer; the other 20% by other variety of tumors.
We shall wait and see what these investigations bring; easier said than done, but would not worry excessively without all the information, take things a day at a time.
Best regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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