Bone metastases

Introduction According to the literature, more than one million new cancer patients are diagnosed each year in the United States, and about 50% of them eventually have bone metastases. The bone metastasis occurs at the site of the central axis and lower limbs, especially the hip area, the primary cancer. Tumors prone to bone metastasis were breast cancer (73.1%), lung cancer (32.5%), kidney cancer (24%), rectal cancer (13%), pancreatic cancer (13%), gastric cancer (10.9%), colon cancer ( 9.3%), ovarian cancer (9%), other common primary bone metastases and prostate cancer. The most common bone metastases occur in the spine, followed by the long bones of the pelvis and lower extremities, and the knees and elbow joints are far less common. The formation of bone metastases is the result of metastasis of the primary cancer through the blood, and the interaction between the tumor cells and the host. The more commonly known metastasis methods are: 1 The primary tumor cells infiltrate the surrounding tissues into the vasculature (blood and lymph). 2 Tumor cell shedding is released in the blood circulation. 3 Tumor cells stay in the blood vessel wall in the bone marrow. 4 Tumor cells then escape through the endothelial cells and then proliferate outside the blood vessels. 5 The blood supply in the metastatic cancer lesions was established to form a bone metastasis lesion.

Cause

Malignant tumor bone metastasis is a complex multi-step process. After the tumor cells reach the bone marrow with the blood flow, the bone tissue is destroyed by interaction with osteoblasts, osteoclasts and bone stromal cells, and various growth factors stored in the bone tissue are released, so that the tumor cells continue to proliferate to form metastases. .

Bone metastasis can be divided into three types: osteolytic, osteogenic and mixed. Generally speaking, the metastasis of breast cancer and lung cancer is mainly osteolytic metastasis, while prostate cancer is mainly osteogenic.

Malignant tumor bone metastasis is mainly bone resorption of osteoclasts, most of which are osteolytic lesions. Even osteogenic bone metastasis is firstly provided by osteoclasts by destroying the bone surface preparation site and providing osteoblasts with tumor-building. basis.

an examination

Related inspection

Bone and joint plain bone and joint soft tissue CT examination of bone and joints MRI examination of serum acid phosphatase

Cancer patients may have bone metastases in cancer when they have symptoms of bone pain.

Symptoms of bone metastasis of lung cancer: There is generally no symptom in the early stage of bone metastasis. Bone isotope scan can detect bones with lesions.

The symptoms of bone metastasis are related to the location and quantity of tumor metastasis. For example, chest pain caused by rib metastasis of lung cancer is often manifested as pain with a clear tender point in the chest wall. Spinal cord metastases cause pain in the center of the back or lesions, and bone metastases in the extremities or trunk cause localized pain in the area.

Differential diagnosis

The symptoms of bone metastasis are related to the location and quantity of tumor metastasis.

1. There is no symptom in the early stage of cancerous bone metastasis. Bone isotope scan can find bones with lesions.

2, chest pain caused by rib metastasis, more manifested as the chest wall site limited, there is a clear tenderness point of pain.

3. Spinal cord metastasis causes pain in the medial or posterior aspect of the back, and bone metastasis of the extremities or trunk causes localized pain in the site.

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