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Shoulder: brachial plexus neoplasia
Introduction
- Locally invasive.
- Rarely metastatic.
- Signs: occasional swinging limb lameness; pain on shoulder extension or axillary palpation; mass may be detectable; muscle atrophy; neurological deficits.
- Treatment: forequarter amputation + removal of any intradural component via laminectomy.
- Prognosis: very guarded.
Presenting signs
- Mostly middle-aged individuals.
- Intractable lameness for several weeks/months.
- Weight-bearing/swinging limb lameness.
- Muscle atrophy varies depending on nerve roots involved.
- Pain on shoulder manipulation, especially extension.
- Pain on axillary palpation.
- Palpable mass.
- Neurological deficits.
Age predisposition
- Middle-aged or older.
- Younger.
Breed/Species predisposition
- Medium to large breeds.
Pathogenesis
Etiology
- Usually primary tumors of the nerve.
- Occasionally secondary tumors, eg osteosarcoma, chondrosarcoma.
Pathophysiology
- Locally invasive.
- May cause spinal cord compression leading to neurological signs in hindlimbs.
- Neurogenic atrophy of muscles may occur.
- Often involves nerve root as it passes out from vertebral column.
- Intradural/extramedullary lesions may be seen.
- Pulmonary metastasis rare.
Timecourse
- Several weeks or months.
Diagnosis
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Treatment
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Prevention
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Outcomes
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