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30 Cards in this Set
- Front
- Back
Where are the most common sites of skeletal mets
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humerus, spine, pelvis, femur
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Where are places that still get metastatic bone lesions but not as common
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skull, ribs , tibia
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How are bony mets spread
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hematogenously
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What part of the bone does mets tend to spread to
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the red bone marrow
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What paart of the vetebral body are bony mets most commonly effect
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the posterior part of the vetebral body (the pedicles first)
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What is the pedicle sign
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this is the result of metastatic destruction of one of the pedicles and it will be absent on AP films
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What percent of skeletal mets are multiple
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90%
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Are mets from prostate cancer blastic
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yes
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What are the 4 primary cancers that comprise 80% of all mets to bone
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Breast
Prostate Lung Kidney |
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What percent of mets to bone does breast cancer make up in women
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70%
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What percent of all mets to bone does prostate cancer make up in men
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60%
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Beside the big four (breast, prostate, lung and kidney which make up 80% of bone mets) what are three cancers are a little less common, but still common for causing mets to bone
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thyroid
Stomach intestines |
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Are most bone mets asymptomatic
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yes
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What is the major symptom of bone mets
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pain from pathologic fractures
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What should be suspected in a fracture of the lesser trochanter in adults
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pathologic fx from mets
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What are the characteristics of a metastatic bone lesion
7 |
multiple
no mass associated with them no periosteal rxn agressive pattern indistinct zone of transition no sclerotic margin may be expansile may produce a soap bubbly (sepatate appearance) |
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What are the 3 aggressive patterns that a metastatic bone lesion will present as
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moth-eaten (mid aggressive)
permeative (most) geographic (least) |
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What is the appearance of a geographic pattern of destruction
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large area of lytic disease
(least aggressive) |
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What does a moth eaten pattern look like
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multiple smaller discreter areas of destruction of with indistinct borders
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What does the permeative pattern look like
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innumerable tiny lytic lesions in the bone
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What are permeative patterns more common in
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round cell lesions like leukemia, lymphoma, ewings, neuroblastoma
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What are the patterns of metastatic disease
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lytic and blastic
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What are the lytic types of metastatic bone lesions
6 |
Breast, Lung, Thyroid, Stomach, Colon
BLT in my Stomach and Colon |
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What are the patterns of osteoblastic mets
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Prostate, Breast, Carcinoid, Medulloblastoma, Seminoma
Breast is Both |
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What may happen to treated lytic mets
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it may become sclerotic and look blastic
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What is an exception to the rules of lytic and blastic type cancers
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The skull tends to have lytic lesions no matter what the cancer is
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What are the characteristics of the lesions caused by kidney and thyroid cancer
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expansile and lytic (soap bubbly)
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What types of cancer causes diffuse skeletal sclerosis or multiple round, well circumscribed sclerotic lesions
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breast or prostate in a male
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What percent of bone lesions will not be visible on plain film but will be positive on bone scans
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10-40%
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What is a superscan (bone scan) in NM
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this is a scan in which there is so much uptake by the bones that the kidneys are no longer visible
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