• Title/Summary/Keyword: Metastatic bone disease

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Metastatic Bone Disease as Seen in Our Clinical Practice - Experience at a Tertiary Care Cancer Center in Pakistan

  • Qureshi, Asim;Shams, Usman;Akhter, Azra;Riaz, Sabiha
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4369-4371
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    • 2012
  • Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.

Cytologic Diagnosis of Metastatic Hepatocellular Carcinoma by Aspiration Cytology of Sacrum (천골의 세침흡인검사로 진단된 전이성 간세포암종)

  • Shim, Jung-Weon;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.1 no.2
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    • pp.179-184
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    • 1990
  • Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2 cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round, centrally located nuclei with single, prominent acidophilic mucleoli. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.

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Metastatic Calcification Revealed by the Bone Scan at Both Lung and a Myocardium (폐와 심근에서 전이성 석회화가 발견된 골 스캔)

  • Song, Hyeon-Seok;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Moo-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.147-148
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    • 2010
  • Introduction: A metastatic calcification is known for taking in bone scintigram medicine at metastatic calcification lesion due to abnormal distribution of the calcium and phosphorus. The one paper reports that a metastatic calcification occurs mainly at lung, stomach, kidney and myocardium. Index: The patient is seventy four years old man who is afflicted with clonic kidney disease, hypercalcemia, hypertension. Because of an ability of the multiple myeloma, we take a bone scan after intravenous injection $^{99m}Tc$-DPD 25 mCi in three hours. We found out homogeneous $^{99m}Tc$-DPD uptake at both lung and myocardium. Conclusions: Nothing unusual was found in other bone scan. We obtains a purity beyond 95 percent at $^{99m}Tc$-DPD vial. In spite of no evidence about a myocardial infarction, the patient has a $^{99m}Tc$-DPD uptake at both lung and myocardium.

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Surgical Treatment of Pathologic Fracture of the Long Bone due to Metastatic Tumor (골전이로 인한 장골의 병적 골절의 수술적 치료)

  • Shin, Kyoo-Ho;Kim, Dong-Soo;Hahn, Soo-Bong;Han, Dae-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.52-59
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    • 1995
  • Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

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Two Cases of Sternal "Cold" Lesions on Bone Imaging in the Metastatic Skeletal Disease (전이성골암(轉移性骨癌)에서 골(骨)스캔상 흉골(胸骨)에 냉소(冷所)로 나타난 2예(例))

  • Park, Hyung-Gun;Seo, Bong-Kwan;Lee, Hoon-Yong;Lee, Myung-Chul;Choi, Sung-Jae;Kim, Noe-Kyeong;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.2
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    • pp.79-82
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    • 1983
  • Traditionally, a positive bone scan shows single or multiple areas of increased uptake in the metastatic skeletal disease. The occurence of "cold" lytic-like or photon-deficient lesions in bone imaging is probably uncommon. Photon-deficient focus or cold lesion of the sternum was demonstrated on $^{99m}Tc-MDP$ bone imaging in 2 individuals with acute myloid leukemia and primary hepatoma, respectively.

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Palliative Radiotherapy for Bone Metastasis (골전이암의 고식적 방사선치료)

  • Kim, Jung-Soo;Huh, Seung-Jae;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.123-128
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    • 1984
  • To determine the effectiveness of radiotherapy for pain control in metastatic bone disease, we retrospectively analyzed the treatment results in 126 patients who received short-course radiotherapr(2,000 rad/1wk vs 3,000 rad/2wks) in the Department of Therapeutic Radiology, Seoul National University Hospital from Feb. 1979 to July 1983. Pain relief was obtained in $82\%$ of patients and complete Pain relief was obtained in $35.3\%$ of patients. The incidence of metastatic bone tumor was highest in spine and pelvis, $43.7\%\;and\;26.3\%$>, respectively. Primary sites of metastasia were lung, breast, unknown primary, stomach, uterine cervix, in order of frequency. There was no significant difference in the response to treatment between 2,000 rad in 1 week and 3,000 rad in 2 weeks.

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BISPHOSPHONATE(ZOLEDRONIC ACID) RELATED OSTEOMYELITIS ON MANDIBLE-A CASE REPORT (Bisphosphonate(Zoledronic acid)와 연관된 하악골의 골수염-증례보고)

  • Lee, Su-Youn;Choi, So-Young;Kim, Jin-Wook;Kwon, Tae-Geon;Jang, Hyung-Jung;Kim, Chin-Soo;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.395-398
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    • 2008
  • Bisphosphonate are a class of drugs with a chemical structure which inhibit bone resorption, actually used for metastatic bone disease, osteoporosis, Paget's disease and multiple myeloma. Significant complication associated with their use is reported recently : mandibular and maxillary osteomyelitis or osteonecrosis. So we here report our case about the patient who was diagnosed of prostate cancer in 2004 April and treated with bisphosphonate(Zoledronic acid-$Zometa^{(R)}$, Novartis Co.) intravenously every 3 to 4weeks at a dose of 4mg to prevent bone metastasis, and also, the patient who came to the hospital due to the bony exposure of mandible and pain in 2006 November and was diagnosed osteomyelitis of mandible as a result of biopsy, bone scan, PET CT examination.

Surgical Treatment for Metastatic Pulmonary Sarcoma (폐전이 골 연부조직 육종에 대한 외과적 치료)

  • 박재길;이선희
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1214-1218
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    • 1997
  • The therapeutic results of pulmonary resection for metastatic bone and soft tissue sarcomas were analyzed. From 1986 to 1996, 14 patients(11 male and 3 female) underwent 15 pulmonary resections for metastatic sarcomas. One(7.1%) patient had 2 thoracotomies for recurrences. The number of metastatic tumors were from one to five. The primary malignant tumors were from bone in 4 and from soft tissues in 10. Mean survival time after thoracotomy was 29.2 months, and Kaplan-Meier's 5-year survival rate from the first metastasectomy was 33.2%. Three patients who had the tumor free interval period over 3 years were alive(mean survival period 52.6 months), whereas eleven patients of the less than 3 years were dead with disease(mean survival period 17.3 months). These results suggested that pulmonary. metastasectomy in bone and soft tissue sarcoma may prolong the survival rate.

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Gastric Carcinoma with Bone Marrow Metastasis: A Case Series

  • Ekinci, Ahmet Siyar;Bal, Oznur;Ozatli, Tahsin;Turker, Ibrahim;Esbah, Onur;Demirci, Ayse;Budakoglu, Burcin;Arslan, Ulku Yalcintas;Eraslan, Emrah;Oksuzoglu, Berna
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.54-57
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    • 2014
  • Gastric cancer is a major cause of cancer-related mortality. At the time of diagnosis, majority of the patients usually have unresectable or metastatic disease. The most common sites of metastases are the liver and the peritoneum, but in the advanced stages, there may be metastases to any region of the body. Bone marrow is an important metastatic site for solid tumors, and the prognosis in such cases is poor. In gastric cancer cases, bone marrow metastasis is usually observed in younger patients and in those with poorly differentiated tumors. Prognosis is worsened owing to the poor histomorphology as well as the occurrence of pancytopenia. The effect of standard chemotherapy is unknown, as survival is limited to a few weeks. This report aimed to evaluate 5 gastric cancer patients with bone marrow metastases to emphasize the importance of this condition.

Surgical Treatment of Metastatic Bone Tumor in Extremity (사지에서 전이성 골종양의 수술적 치료)

  • Lee, Han-Koo;Lee, Sang-Hoon;Baek, Goo-Hyun;Lee, Chang-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.45-51
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    • 1995
  • The incidence of metastatic bony lesion has been increased recently, with the advanced therapeutic modalities of malignant tumors. The purpose of this study was to evaluate the effectiveness of surgical treatment in impending or established pathologic fractures due to metastasis in extremity. From 1981 to 1992, thirty two patients who had established or impending pathologic fractures in extremity had been treated surgically. The locations of metastasis, were lower extremity in 24 cases(femsral head and neck;5, intertrochanteric;7, subtrochanteric;8, femoral shaft;4) and upper extremity in 8 cases(proximal humerus;2, humoral shaft;6). The method of surgery was excision of tumor mass and rigid internal fixation to allow immediate mobilization, except 2 cases of amputation. The results were analysed by two criteria. The first was the grade of performance status that was made by modification of Functional Classification of New York Heart Association. The second was the degree of pain relief. The performance status was improved at least one grade in all patients and the mean improvement was 1.7 grades. The satisfactory pain relief was achieved in 81% of patients. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and they became comfortable at rest and ordinary activities. The solitary metastatic lesions showed better pain relief(92%) than multiple metastasis(75%). The curative surgery was done in 3 cases, and they showed more than 24 months of disease-free survival.

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