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30 Cards in this Set

  • Front
  • Back
Where are the most common sites of skeletal mets
humerus, spine, pelvis, femur
Where are places that still get metastatic bone lesions but not as common
skull, ribs , tibia
How are bony mets spread
hematogenously
What part of the bone does mets tend to spread to
the red bone marrow
What paart of the vetebral body are bony mets most commonly effect
the posterior part of the vetebral body (the pedicles first)
What is the pedicle sign
this is the result of metastatic destruction of one of the pedicles and it will be absent on AP films
What percent of skeletal mets are multiple
90%
Are mets from prostate cancer blastic
yes
What are the 4 primary cancers that comprise 80% of all mets to bone
Breast
Prostate
Lung
Kidney
What percent of mets to bone does breast cancer make up in women
70%
What percent of all mets to bone does prostate cancer make up in men
60%
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
thyroid
Stomach
intestines
Are most bone mets asymptomatic
yes
What is the major symptom of bone mets
pain from pathologic fractures
What should be suspected in a fracture of the lesser trochanter in adults
pathologic fx from mets
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)
What are the 3 aggressive patterns that a metastatic bone lesion will present as
moth-eaten (mid aggressive)
permeative (most)
geographic (least)
What is the appearance of a geographic pattern of destruction
large area of lytic disease

(least aggressive)
What does a moth eaten pattern look like
multiple smaller discreter areas of destruction of with indistinct borders
What does the permeative pattern look like
innumerable tiny lytic lesions in the bone
What are permeative patterns more common in
round cell lesions like leukemia, lymphoma, ewings, neuroblastoma
What are the patterns of metastatic disease
lytic and blastic
What are the lytic types of metastatic bone lesions
6
Breast, Lung, Thyroid, Stomach, Colon
BLT in my Stomach and Colon
What are the patterns of osteoblastic mets
Prostate, Breast, Carcinoid, Medulloblastoma, Seminoma

Breast is Both
What may happen to treated lytic mets
it may become sclerotic and look blastic
What is an exception to the rules of lytic and blastic type cancers
The skull tends to have lytic lesions no matter what the cancer is
What are the characteristics of the lesions caused by kidney and thyroid cancer
expansile and lytic (soap bubbly)
What types of cancer causes diffuse skeletal sclerosis or multiple round, well circumscribed sclerotic lesions
breast or prostate in a male
What percent of bone lesions will not be visible on plain film but will be positive on bone scans
10-40%
What is a superscan (bone scan) in NM
this is a scan in which there is so much uptake by the bones that the kidneys are no longer visible