Destructive humerus lytic lesion in metastatic breast cancer

Breast cancer is the most common site of origin of metastatic deposits in the skeleton as well as the most common site of recurrence of breast cancer. Metastasis to the bone arises in 20% to 60% of patients and in up to 70% to 85% at autopsy. When the humerus is involved, almost 90% of lesions arise in the proximal (42%) and diaphyseal (47%) regions. Metastases to the distal humerus are more infrequent, accounting for only 11% of cases. A 37-year-old female presented with a history of right breast lump for the past 6 months which was painless. She had no previous history of breast disease. She complained of right shoulder pain for the last 2 months. Examination of the right shoulder showed intact distal neurovascular state with limitation of abduction to 90 degrees and external rotation to 30 degrees.