Metastatic Bone Disease Flashcards
where does metastatic bone disease come from?
arises from a primary extra skeletal site
what are the most common primary sites for metastatic bone disease?
breast, lung, prostate, kidney, thyroid, and bowel
what 3 types of lesions can metastatic bone disease create?
- blastic
- lytic
- expansile (very rare)
how does a blastic lesion look on x ray?
more white, builds bone.
how does a lytic lesion look on x ray?
it looks like there is a hole in the bone.
osteoclasts are stimulated
what is the most common primary site of origin for metastatic disease in women?
the breast, 70% of cases of metastatic disease come from the breast.
80% being lytic,
10% being blastic.
what is the most common primary site of origin for metastatic disease in men?
from the prostate.
80% being blastic.
10% being lytic.
lung carcinoma is mostly lytic
if a metasatic lesion is expansile in a woman, what is the most likely primary site?
thyroid or kidney
what is the most common path way of metastasis?
most common= hematogeneous dissemination (blood). Commonly through the Batson’s plexus.
then, lymphatic dissemination, and direct extension.
what lab exams are done for metastatic disease?
ESR
Serum calcium
Alkaline phosphatase (this increases with increased bone production)
acid phosphatase and/or PSA antigen
what age is metastatic disease most common?
4th decade of life (30’s)
what is a common first sign for metastatic disease?
a pathologic fracture (or a vertebral body, rather than only the anterior 2/3 of body collapsing)
what type of marrow do the areas with metastatic disease have?
red marrow
what are common sites for metastasis?
- Spine (40%)
- Ribs and sternum
- Pelvis and sacrum
- Proximal extremities
- Skull
Radiographic features of vertebral metastasis (6)
- ivory vertebra
- pedicle destruction
- pathologic collapse
- focal osteoporosis of body–one vertebral body less dense than the others
- malignant Schmorl’s node formation
- gross destruction of bone
