Bone
Other tumors of bone
Metastases to bone

Author: Nat Pernick, M.D.

Revised: 28 December 2017, last major update 2005

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: "metastases to bone" [title]

Cite this page: Pernick, N. Metastases to bone. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonemetstobone.html. Accessed February 20th, 2018.
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
Images hosted on PathOut server:

Images contributed by Dr. Mark R. Wick

Breast carcinoma

Lung carcinoma to metatarsal

Prostate adenocarcinoma

Thyroid carcinoma



Images from AFIP

Lung carcinoma metastasis

Prostate carcinoma - osteoblastic features

Thyroid carcinoma

Case reports
Treatment
  • Radiation therapy for pain relief and to prevent fracture of weight bearing bones
Gross images
Images hosted on PathOut server:

Images contributed by Dr. Mark R. Wick

Lung carcinoma in humeral head

Lung squamous cell carcinoma

Microscopic (histologic) images
Images hosted on PathOut server:

Images contributed by Semir Vranić, M.D., Ph.D.

Various images



Images contributed by Dr. Mark R. Wick

Lung carcinoma to metatarsal

Lung carcinoma to metatarsal

Lung carcinoma to metatarsal TTF1

Prostate adenocarcinoma

Renal cell carcinoma



Images from AFIP

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