Tumors and Tumor-Like Processes, Chapter 11 Flashcards
What is the most common bone tumor ?
Metastatic bone tumor
Compare primary bone tumor with metastatic bone tumor how much are these account for (%) ?
30% : 70%
Majority of metastasis bone tumors are from ?
A) Extraskeletal origin
B) Skeletal origin
Extraskeletal origin, mostly are epithelial tumor
For Extraskeletal metastasis to bone what are the organ origin that metastasis come from ?
For Skeletal origin what primary bone tumor do have metastasis ?
Extraskeletal metastasis:
Breast, lung , prostate, kidney, thyroid and bowel
Bone to Bone metastasis:
Ewing sarcoma
What tumors rare or no report to have bony metastasis ?
CNS tumor and basal cell carcinoma of skin
What is the usual route of bone metastasis ?
Vascular (hematogenous)
Between the axial skeletal, skull, proximal extremities and distal to the knee and elbow
Which sites are rare to have metastasis ?
Distal to the knee and elbow.. are rare.
In organ of metastasis
the bone meatstasis is in the 1st, 2nd or 3rd most common site of metastasis ?
3rd common site of metastasis
As known multiple bone metastasis usually occur, how much do solitary metastasis occur (%) ?
10%
In female, male and young age group (<20 yr) please ranking the two most common primary tumor in each patient group that has bone metastasis ?
Female:
> (70%) Breast
> (30%) thyroid, kidney and uterus
Male:
> (60%) Prostate
> (25%) Lung
Young age group, must classify by age
- s Lymphoma
- What are common symptoms of bone metastasis ?
2. What are the primary tumor that usually exhibit symptom of bone metastasis ?
1) Pain and Pathologic fracture
> Pain, classically norturnal and persistent pain, but often lacking of these characteristic symptoms
2) Thyroid, Liver and Kidney
When developed bone metastasis, how the following lab test will change ?
- ESR
- ALP
- Ca++
- PSA
- ESR: Often elevate, non-specific
- ALP: Often elevate in blastic metastasis, Non-specific may rise from liver dz or fx.
- Ca++: In diffuse lytic lesion may elevated but most case normal,
- PSA: when >10 ng/ml CAP usually breakthrough capsule and has bone metastasis.
+ PSA <10 ng/ml full body bone scan not recommended, except with clinical bone pain
About pathway of metastasis, do lymphatic spread common in bone metastasis ?
No, เชื่อว่าใน bone ไม่มี lymphatic channel จึง low incidence
About pathway of general metastasis, please give example of direct extension ?
Example of direct extension are
- Uterine carcinoma to iliac bone
- Surgical implantation
- Downstream seeding
ie UCC (TCC) or intestinal tumor
Between artery and vein which one are subjected to cause tumor emboli ?
Vein.
From arteries are thick walled which resist tumor penetration, while vein are thin walled.
The cancer usually slough off in venous and form tumor emboli.