Bone & joints
Other tumors
Metastases
Author: Nat Pernick, M.D.
Last author update: 1 June 2005
Last staff update: 28 February 2023
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed search: "metastases to bone" [title]
Table of Contents
Definition / general | Radiology images | Case reports | Treatment | Gross images | Microscopic (histologic) images | Differential diagnosisCite this page: Pernick N Metastases. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bonemetstobone.html. Accessed December 20th, 2024.
Definition / general
- Most common malignant bone tumor is metastatic carcinoma
- In adults, 80% from prostate, breast, kidney, lung or thyroid
- In children, from neuroblastoma, Wilm tumor, osteosarcoma, Ewing / PNET or rhabdomyosarcoma
- Intraspinal seeding may occur along Batson’s plexus of veins
- Positive isotope bone scans (versus myeloma)
- Sarcomatoid carcinoma: consider if patient 60+ years with spindling bone malignancy; cells usually plumper than bone sarcomas and accompanied by carcinoma; renal cell carcinoma is most common primary site
- Common sites: axial skeleton, proximal femur, proximal humerus; usually marrow; very rare to be distal to elbow or knee
- Solitary metastases: kidney, thyroid
- Small bones of hands and feet: colon, lung, kidney
- Blastic lesions: prostate, carcinoid tumor, neuroendocrine tumors
Radiology images
Contributed by Mark R. Wick, M.D. and AFIP images
Breast carcinoma
Lung carcinoma to metatarsal
Prostate adenocarcinoma
Thyroid carcinoma
Lung carcinoma metastasis
Prostate carcinoma - osteoblastic features
Thyroid carcinoma
Case reports
- 37 year old man with spinal cord compression (Arch Pathol Lab Med 2003;127:887)
- 63 year old woman with metastatic basal cell carcinoma to vertebrae in nevoid basal cell carcinoma syndrome (Arch Pathol Lab Med 2004;128:819)
Treatment
- Radiation therapy for pain relief and to prevent fracture of weight bearing bones
Gross images
Contributed by Mark R. Wick, M.D.
Lung carcinoma in humeral head
Lung squamous cell carcinoma
Microscopic (histologic) images
Contributed by Semir Vranić, M.D., Ph.D., Mark R. Wick, M.D. and AFIP images
Bone metastasis
Primary prostate adenocarcinoma
Lung carcinoma to metatarsal
Lung carcinoma to metatarsal
Lung carcinoma to metatarsal TTF1
Prostate adenocarcinoma
Renal cell carcinoma
Lung: metastatic carcinoma
Lung: metastatic carcinoma BerEp4
Prostate: metastatic carcinoma
Thyroid: metastatic carcinoma
Differential diagnosis
- Myeloma:
- Negative isotope bone scan, monoclonal protein in serum or urine
