Giant humeral enostosis

Case contributed by Dr Salman S. Albakheet

Presentation

Shoulder pain after right arm trauma ( proximal humerus lesion detected incidentally).

Patient Data

Age: 30 years
Gender: Female

Large right proximal humerus dense sclerotic bony lesion within the medullary space. It's margins show thorny radiation appearance. The long axis of the lesion is parallel to the long axis of the right humerus bone. It measures approximately 4.4 cm. 

Increased radiotracer uptake in the right proximal humerus, more likely benign bone lesion.

About 4.4 cm well-circumscribed mass with spiculated (feathery) margin and low signal intensity on all MRI sequences (compact bone) at proximal right humerus. Its long axis is oriented parallel to the cortex. 

Case Discussion

The lesion was detected incidentally after imaging the patient who suffered from right shoulder pain, following right arm trauma. Although it had a benign appearance, further screening and evaluation by whole body bone scan (to exclude an osteoblastic metastasis or osteosarcoma) and MRI to further characterize the lesion was done. The mass showed typical features of a bone island. It is called a giant bone island, since its size exceeds 2 cm, reaching about 4.4 cm 1.

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