Metastatic Bone Disease (DRAFT)

Question 1

Metastatic bone tumors are also called ____

Answer 1

secondary bone tumors

Question 2

What is the most common malignant tumor of bone?

Answer 2

metastatic disease

Question 3

What is metastatic bone disease?

Answer 3

neoplasias (usually carcinomas) that metastasize to bone from any tissue in the body

Question 4

What are the most common primary origins of metastasis to bone?

Answer 4

• breast
• prostate
• kidney
• lung

Question 5

What is the most common pathway of metastatic spread and why?

Answer 5

hematogenous
- vascular angiogenesis
- tumor cells not sticky, shed easily into blood

Question 6

What cancer has the highest mortality rate?

Answer 6

lung & bronchus

Question 7

What are the common sites of metastasis in the skeletal system?

Answer 7

• vertebrae (l/s due to gravity)
• pelvis
• ribs
• skull
• sternum

Question 8

How does hematogenous metastatic spread commonly occur to the skeleton?

Answer 8

Baxon’s vertebral plexus –> red marrow spaces

Question 9

Primary breast cancer often metastasizes via what route?

Answer 9

lymphatic

Question 10

A pancoast tumor that metastasizes to the upper ribs and thoracic spine spreads via what route?

Answer 10

direct extension

Question 11

What are the 2 most common clinical manifestations of metastasis to bone?

Answer 11

1. unexplained weight loss
2. anemia manifesting as fatigue

Question 12

What are the clinical manifestations of metastasis?

Answer 12

• unexplained weight loss
• anemia (fatigue)
• pain
• fever (night sweats) with late stage
• abnormal labs

Question 13

What are the possible radiographic characteristics of metastasis to bone?

Answer 13

osteoblastic, osteolytic, or mixed activity