see: [Dunn - Bone tumours](x-devonthink-item://3DF2635A-D902-42C9-9F07-5EC9A2A183D1), [Dunn - multiple myeloma](x-devonthink-item://2FC5E73A-B781-4086-8E32-8FB246F0D2CB) [[Bone metastasis]] # metastatic tumours - more common than primary tumours - osteolytic > osteoblastic - may present with pathological fractures or bone pain - pain is absent in 70% of metastases - however, bone pain is the most common cause of metastatic pain - children less likely than adults to have bone involvement - neuroblastoma and leukaemia - common bones involved: - spine - ribs - pelvis - skull - proximal femur and humerus - rare below the knee or elbow **most common cancer mets to bone:**  lung, breast, kidney, prostate, thyroid, colon, adrenal, myeloma, neuroblastoma, ewing's sarcoma **lytic bone mets:** kidney, lung, colon, melanoma, renal, lymphoma, thyroid **blastic bone mets:** prostate and breast carcinoma, Hodgkin's lymphoma *DDx osteolytic lesions:* - mets - RCC - small cell lung carcinoma - thyroid - melanoma - lymphoma - osteoarthritis (subchondral cysts, schmorl nodes) - metabolic bone disease - cystic angiomatosis - histiocytosis - infiltrative bone marrow lesions *DDx osteosclerotic lesions* - mets - prostate - carcinoid - Small cell lung - Hodgkin's lymphoma - meduloblastoma - bone islands - tuberous sclerosis - mastocytosis - osteopoikilosis --- # Malignant primary bone tumours - aneurysmal bone cyst - osteosarcoma - chondrosarcoma - giant cell sarcoma - Ewing's tumour - baget's sarcoma - irradiation sarcoma ![[Photo Jun 23, 2020 at 110617 PM.jpg]]