Humeroplasty for pain control in multiple myeloma

Abstract

Pathological fractures in patients with primary skeletal cancer or metastases are associated with significant morbidity and poor prognosis. We present three cases of patients with osseous pain despite having received radiotherapy and multimodal analgesic management. Humeroplasty was offered to treat pain and decrease the risk of fracture. We report three patients with osseous pain secondary to osteolytic tumoral activity in the humerus and a Mirels score >7. Humeroplasty was performed under sedation and under fluoroscopy guidance. The three patients reported a decrease in pain most significantly with incidental pain and improved mobility. There were no fractures noted and no other complications. Percutaneous humeroplasty could be an option in multiple myeloma patients with impending humeral fractures, especially when the osteolytic lesion is localized in the humeral head. The procedure provided good pain relief to the patient. However, more studies should be conducted to asses efficacy and complications.