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Metastatic Bone Lesions

Metastatic Bone Cancer: Pathogenesis & Clinical Findings Primary solid tumours from breast, prostate, or lung commonly migrate into bones Bone Metastases Migration of primary solid tumours (commonly from the breast, prostate, or lungs) into bones. Once tumours metastasize to bone, they are generally incurable and contribute to significant morbidity prior to a patient’s death Authors: Curtis Ostertag Reviewers: Mankirat Bhogal Nojan Mannani Michelle J. Chen Dr. Gerhard Kiefer* * MD at time of publication Cell-to-cell communication between tumour cells & bone cells (osteoclasts & osteoblasts) Tumours release TNF-⍺, RANK-L, and PTHRP which ↑ osteoclast activity & ↓ osteoblast activity Change in relative activity of bone cells results in osteolysis (breakdown of bone) Calcium is released into the bloodstream Hypercalcemia Osteoblastic metastasis (common in prostate cancer) Tumor growth Secondary bone formation in response to bone destruction TGF-β, PDGF, & IGF are released from the degraded bone matrix, which can stimulate tumors & osteoblasts Weakened bone increases risk of fracture Pathologic fracture ↑ Mortality Bone tissue expands into surrounding space Nerve compression Disruption of cortical bone or surrounding soft tissues Diffuse & achy rest/night pain Long bone masses compress peripheral nerves Neuropathy Vertebral masses compress spinal nerves/cord Radiculopathy /Myelopathy ↓ Quality of life Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Jun 9, 2024 on www.thecalgaryguide.com