Bone tumours

Bone Metastases

In middle and later age, osseous metastases are more common than primary malignant bone tumours. In children and adolescents the reverse applies; a malignant bone lesion in a patient of this age is far more likely to be a primary malignant bone tumour than bone metastases.

In an older patient (> 40 years old) with multiple osseous lesions, the first diagnosis to consider is bone metastases (fig. 24). A second possible diagnosis is multiple myeloma. Osseous metastases can be lytic, sclerotic (= blastic) or mixed. Many carcinomas of the breast and prostate produce osteoblastic metastases. In contrast, lung carcinomas are often associated with osteolytic metastases.