Bone & joints

Other tumors

Metastases



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Last staff update: 18 January 2022

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PubMed search: "metastases to bone" [title]


Nat Pernick, M.D.
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Cite this page: Pernick N Metastases. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bonemetstobone.html. Accessed July 5th, 2022.
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
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
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