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What is Which of the following is the most common cause of sclerotic skeletal metastasis in a female patient? and explain in detail?
Ans. is 'a' ie Carcinoma breast (Ref: Grainger and Allison's Diagnostic Radiology, 4/e, p1873)."Most lesions (of breast carcinoma) are osteolytic but breast carcinoma is also the commonest cause of an osteoblastic metastasis in a woman" - Grainger & AllisonSkeletal metastasis may be osteolytic or osteoblastic.Although some tumors like renal cell carcinoma may produce purely osteolytic lesion majority of metastasis are mixed type - predominantly osteolytic.Predominantly osteoblastic lesions arise fromProstateStomach Carcinoid.Also RememberMost common sites of primary for bone metastasis.In males Prostate > LungIn Female Breast > LungIn Children Neuroblastoma.Most common cause of osteolytic metastasis.In male Lung Cancer.In Females----- Breast CancerMost common cause of osteoblastic metastasisIn males Prostate CancerIn females Breast CancerSkeletal sites most frequently involved.Spine > proximal femur > pelvis > ribs > sternum > proximal humerus > skullLytic expansile metastasis seen inRenal CancerThyroid carcinoma.Bone metastasis with soft tissue mass.Renal CancerThyroid carcinoma.Osteolytic lesions are associated with hypercalcemia and excretion of hydroxyproline - containing peptides.Osteoblastic lesions are associated with increased levels of serum alkaline phosphatase.Metastasis distal to knee and elbow is rare and usually arises from a primary tumors of theBronchusColon orBladder.