Pattern of Metastatic Bone Disease- an Observational Study (original) (raw)

Journal of Evolution of Medical and Dental Sciences

BACKGROUND Metastasis to the skeletal system is commonly associated with lung, prostate and breast cancers. The pattern of metastatic spread varies depending on the type of the primary tumour and its site. This study aimed to assess the pattern and anatomical distribution of skeletal metastases in histologically proven malignancies. MATERIALS & METHODS 128 consecutive cancer patients with evidence of skeletal metastasis were evaluated for the anatomical distribution of bone metastases. The clinical presentation of the metastatic bone disease was documented and the pattern of skeletal metastasis in various cancers evaluated. RESULTS The 128 patients (76 males and 52 females) consisted of 45 patients (35.2%) with lung cancer, 41 patients (32%) with prostate cancer, 19 patients (14.8%) with breast cancer, 9 patients (7%) with gastrointestinal cancer, 7 patients (5.5%) with renal cell carcinoma and other miscellaneous tumours in the remaining 7. Spine was found to be the most common site of skeletal metastasis (57.8%), followed by pelvic bones (22.6%) and ribs (14.8%). Lung cancers metastasized to spine, pelvis, ribs, scapula, humerus and sternum. Prostate and breast cancers had metastatic lesions in the spine, pelvis, ribs, scapula, femur, sternum, clavicle, and tibia. The clinical presentation varied from no specific symptoms to bone pain, neurological deficit and pathological fracture. CONCLUSION Bone metastasis has been found to occur in a predictable pattern. Thus, the knowledge of the usual pattern of metastasis in the commonly seen malignancies will enable the clinician to formulate a thorough work-up for the diagnosis and management of metastatic bone disease.