My Orthopaedic Surgeon

Grand Rounds Presentation McMaster 2005

Discussion; Types; Work-up; Treatment

Hyperguide Pre-Test and tutorial

eMedicine article

This condition rarely occurs in patients who have a biopsy proven cancer but no known primary lesion. The oncologist must rely upon the pathologist to use their diagnostic skills to render a likely source which may guide the therapy.

rovides an overview, facts and stastistics related to metastatic bone cancer. Includes links to breast, lung and kidney cancer sites because these cancers are most likely to metastasize to the bone. Includes treatment goals.

fractures which occur from low energy injuries which occur thru an area of bone weakness with a pre-existing abnormality; - injured area demonstrates distored archetecture and distored bone density;

Pathologic Humerus Fracture Reuben Gobezie MD, Brent A. Ponce MD, John Ready MD DEPARTMENT OF ORTHOPAEDICS, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON MA Introduction Bony lesions may result in pathologic fractures. These lesions, when not of mesenchymal origin, commonly include myeloma, lymphoma, and most commonly metastastic carcinoma. The axial skeleton is the third most common site of bony metastasis, after the lung and liver. Of the 1.2 million new cases of cancer each year in the United States, one half will metastasize to the skeleton1. The tumors most likely to metastasize to bone are prostate (32%), breast (22%), kidney (16%), lung and thyroid1. Metastatic disease to the axial skeleton occurs much more frequently in the spine, pelvis, ribs, and lower extremities than in the humerus. Yet, metastasis to the humerus accounts for 20% of osseous metastasis. The humerus is the second most common site for long bone metastases, behind only the femur in its frequency of involvment. In multiple myeloma, the majority of patients have pathologic fractures at the time of diagnosis, and up to 30% of patients present with non-vertebral fractures2. Metastasis to the long bones usually reflects an advanced disease state. It has been recommended that the majority of patients with metastatic bone tumors receive multidisciplinary care from a team including orthopaedic oncologists, radiotherapists, and oncologists.

Xray and bone scan

sclerotic bone metastases. Notes, links and Images

Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan Kuo-Yuan Huang , Chrong-Reen Wang and Rong-Sen Yang BMC Musculoskeletal Disorders 2007, 8:70 doi:10.1186/1471-2474-8-70 (Full Text) Conclusions Due to the high morbidity and poor survival of Taiwanese patients with osseous metastases of melanoma, surgical treatment should be directed towards pain relief and the prevention of skeletal debilitation in order to maintain their quality of life.

BMJ 2006;332:1227-1228 (27 May), Editorial
Orthopaedic procedures can help terminally ill patients and are underused Wisam I Al-Hakim, clinical research fellow, bone tumour unit (wisam2410@hotmail.com), Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP Jacub M Jagiello, clinical research fellow, bone tumour unit, Ken Mannan, specialist registrar, Tim W Briggs, consultant orthopaedic surgeon
Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP

Full text of Review article in JBJS B 2001 83-B:471-81

- Osteosarcoma (common)
- Ewing's sarcoma: (common)
- chondrosarcoma
- Osteochondroma (Osteocartilaginous Exostosis)
- Fibrous Dysplasia
- Eosinophilic granuloma
- Aneurysmal bone cyst
- Prostatic Ca: - most of prostatic ca mets are blastic & do not require stabilization; - however, a defect in the ilium may weaken the acetabulum and should be surgically treated;
Wheeless' Textbook of Orthopaedics

bone metastases