Is there an Association between Trauma and Musculoskeletal Tumours? A Review of the Literature

Abstract

There is a relatively high incidence of patients recalling an injury before the appearance of a musculoskeletal (MSK) mass, especially in the hand and upper limb. Despite numerous reports of such cases, no clear pathogenetic mechanism has been elucidated to explain this. A tumour may be pre-existing, with the injury bringing the patient's attention to it, or develop coincidently following trauma. Alternatively, injury or the resultant reparative mechanisms may initiate or accelerate tumour formation. Following such a case presenting to our unit, a narrative review of the literature was conducted to determine what evidence existed to support or refute these hypotheses. This is presented along with the case. Though trauma as a cause of MSK tumours cannot be excluded, there is a lack of scientific evidence to support this theory, and further research in the field of pathophysiology and molecular biology is necessary. It is important that clinicians caring for trauma patients maintain a high index of suspicion for alternate diagnoses. A local injury may mask tumour development and lead to the incorrect conclusion that persistent symptoms are the result of failure to recover from the injury, rather than having a more sinister explanation.

How to cite this article: Athanaselis ED, Koskiniotis A, Sourmenidi A, et al. Is there an Association between Trauma and Musculoskeletal Tumours? A Review of the Literature. Strategies Trauma Limb Reconstr 2024;19(3):149-155.

Keywords: Hand tumour; Malignancy; Musculoskeletal tumour; Neoplasia; Oncogenesis; Sarcoma; Soft tissue tumour; Trauma.

Flowchart 1

Flowchart of the literature research

Figs 1A to C

Clinical appearance of left popliteal fossa of a 14-year-old girl with oedema and bruise restricting flexion and extension of the knee joint after a blunt injury 15 days before

Figs 2A to D

(A) Magnetic resonance imaging of the soft tissue mass in axial; (B) Coronal; (C) T2-weighted sagittal; and (D) T1-weighted sagittal views

Fig. 3

Ewing sarcoma was diagnosed by histopathology findings: Mitotic activity, solid areas of uniform, undifferentiated round cells with a few cytoplasm and indistinct cell borders, partially middle-sized cells with moderate nuclear pleomorphism, occasionally with prominent nucleoli and eosinophilic cytoplasm (H&E 20×)