(Benign and Malignant Lumps That Can Imitate Bursitis)
A painless lump or persistent shoulder pain deserves a prompt scan.
Early diagnosis saves bone, function, and sometimes life.
Why read this leaflet?
- The majority of painful shoulders are due to soft-tissue conditions (e.g., bursitis or tendon tears).
- A small minority are caused by tumours growing in, or near, the bones around the sub-acromial bursa (the natural cushion under your acromion).
- Recognising the warning signs means you and your doctor can arrange the right scans quickly.
What types of tumour occur here?
Category | Typical examples | Usual behaviour |
Benign (non-cancerous) | Lipoma (fat lump), benign osteochondroma (bony lump), simple bone cyst | Grow slowly, rarely spread |
Borderline / locally aggressive | Giant-cell tumour, aneurysmal bone cyst | Can erode bone; may recur if not removed fully |
Malignant (cancerous) | Osteosarcoma, Ewing sarcoma, chondrosarcoma, secondary spread from breast, prostate or lung cancer | Invade bone and may spread to lungs |
Symptoms that raise suspicion
- Hard or painless lump on or behind the shoulder
- New swelling following only minor injury
- Pain that wakes you at night
- Unexplained fractures after minimal force
- Reduced movement that does not improve with rest or physiotherapy
- Unexplained weight loss or night sweats
Key point: A lump noticed after an injury often pre-dates the bump; the knock simply draws attention to it.
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How are tumours diagnosed?
- Clinical exam– doctor checks size, tenderness, and shoulder function.
- Plain X-ray– shows bone structure; many malignant tumours have a recognisable pattern.
- MRI or CT– defines extent and soft-tissue involvement.
- Core needle biopsy– small tissue sample analysed by a specialist bone-tumour pathologist.
- Blood tests & chest imaging– look for spread or other causes.
Treatment principles
Tumour type | Typical management |
Benign lipoma / osteochondroma | Surgical removal only if painful, growing, or cosmetically troublesome |
Simple bone cyst | Observation ± steroid injection or bone graft packing |
Giant-cell tumour | Extended curettage, bone-cement filling, ± drug therapy (denosumab) |
Primary bone cancers | Combined care in a specialist sarcoma centre – limb-sparing surgery, chemotherapy and/or radiotherapy |
Metastatic lesions | Treat primary cancer, stabilise bone (cement or metal rod), pain control |
Early referral to a regional sarcoma MDT (multidisciplinary team) is essential for any suspected malignancy.
Clinical pearls
- Lipomas are common around the shoulder and often blamed for pain that actually comes from a tendon injury.
- A single bone cyst in a child’s humerus may fracture painlessly and mimic a sports injury.
- Osteosarcoma under age 25; chondrosarcoma over age 40; metastasis over age 60 are typical age rules of thumb.
- The tumour team must plan biopsy – an ill-placed biopsy can complicate later curative surgery.
00Patient FAQs
Is every lump cancer?
No. Most shoulder lumps are benign; however, only imaging (and sometimes biopsy) can say for sure.
Will surgery weaken my arm?
Modern limb-sparing techniques use plates, rods or custom implants to maintain strength. Rehabilitation is key.
If a tumour is benign, can I leave it alone?
Often yes, provided it is pain-free, not enlarging, and confirmed by imaging. Regular review is advised.
Do small injuries cause cancer?
Current evidence suggests bumps draw attention to an existing lesion rather than create one.
Call-to-Action
Concerned about a lump or stubborn shoulder pain?
Phone 020 3384 5588Â
Email info@TheArmDoc.co.ukÂ
 Visit www.TheArmDoc.co.uk
Disclaimer
This leaflet offers general information, not personalised medical advice. Always consult a qualified healthcare professional for assessment and treatment of any shoulder problem.
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