An epidemiological survey of tumour or tumour like conditions in the scapula and periscapular region

Introduction: The scapula is not an uncommon site for bone and soft tissue tumours and can be difficult to delineate on examination. Furthermore, these lesions can be potentially challenging to biopsy due to its close anatomical relationship with important structures. We present an epidemiological survey of all the scapular and periscapular lesions presenting to our institution. Methodology: This was a retrospective study with data obtained from a prospectively held electronic database over a 30-year period. Demographic and clinical data was obtained and various subgroup analyses were performed. Results: A total of 418 scapular lesions were included in the study where 132 lesions were found to be of soft tissue origin and 286 were osseous. Fifty-eight percent (n = 241) of all these lesions were malignant, of which 47% (n = 113) were primary sarcomas. The commonest malignant lesions were bone sarcomas (n = 96) followed by metastases (n = 88). The commonest primary bone sarcoma was chondrosarcoma (45%), whereas the commonest soft tissue sarcoma was high grade undifferentiated pleomorphic sarcoma (18%). The most common benign osseous and soft tissue lesions were osteochondroma (70%) and lipoma (26%), respectively. We noted that the incidence of malignancy increased with increasing age, however, the incidence of primary bone sarcomas was fairly consistent across different age groups. Conclusion: Based on our findings we recommend that suspicious lesions arising from the scapula should be dealt with in a specialist sarcoma unit with involvement of a multidisciplinary team to offer appropriate management and advice for optimum outcome.