Avascular Necrosis of Humeral Head after Thalidomide Use: A Report of Two Cases

Background: Thalidomide is an immunomodulatory drug which is used for treatment of certain cancers such as multiple myeloma. Multiple Myeloma (MM) is a cancer that creates a specific type of white blood cell called plasma cell and accumulates these cancerous cells in bone marrow. To our knowledge, there is no report of avascular necrosis of humeral head after thalidomide use; hence, the aim of present study was to report two cases of avascular necrosis of humeral head after thalidomide use in MM patients. Case reports: Twenty five patients with history of MM were evaluated for the adverse effects of thalidomide from 2008 to 2014 at Department of Orthopedics, Isfahan University of Medical Sciences-Isfahan- Iran. All cases were assessed by X-ray and bone scan. Conclusion: Out of 25, two cases were diagnosed with avascular necrosis of humeral head with pain in shoulders. It seems that thalidomide can cause necrosis in humeral head.