Skeletal metastases in a k/c/o Ca Breast
Metastases to bone
- 15- 100 times more common than primary skeletal neoplasm!
Mode of spread: through bloodstream/ lymphatic/ direct extension
Location- predilection for marrow containing skeleton (skull, spine, ribs, pelvis, humeri, femora)
- single/ multiple lesions of variable size
- joint space sand intervertebral spaces preserved( cartilage resistant to invasion)
a) Osteolytic bone metastases
Primary- Neuroblastoma, lung cancer, breast Ca, thyroid Ca, kidney, colon
- may begin in spongy bone ( associated soft tissue mass in ribs)
- vertebral pedicles often involved
b) Osteoblastic bone metastases
- Evidence of slow growing neoplasm
Primary- prostrate, breast, lymphoma, malignant carcinoid, medulloblastoma, mucinous adenocarcinoma of GI tract, TCC of bladder, pancreas, neuroblastoma
c) Mixed bone metastases
Primary- breast, prostrate, lymphoma.
d) Expansile bone metastases
Primary- thyroid, kidney
e) Permeative bone metastases
Primary- Burkitt lymphoma, mycosis fungoides.