Metastatic Bone Tumors: Diagnosis and Treatment

Seventy-four cases of metastatic bone tumors were reviewed inorder to study the actual problems concerning their diagnosisand treatment. Sixty-five of the 74 tumors were carcinoma metastasesand the remaining nine were other malignancies. Diagnosis: In our study, as has often been reported elsewhere,there was a high incidence of metastasis of lung and breastcancer (27% and 9%, respectively). In all patients in this series,the existence of bone metastasis itself was shown by plain radiogramsat the time of their admission. In 51 patients, primary siteswere identified by clinical records and/or various clinicalexaminations. Autopsy revealed additional seven primary sites. Treatment: Limb surgery which directly intends a resection ofthe metastatic lesion generally provided good palliation and,on occasion, relatively long survival. Of the seven patientswhose bone lesions were enthusiastically resected, three survivedfor 15, 27 and 36 months postoperatively and one has survivedup to the present (18 months). On the other hand, laminectomy and other procedures of vertebralsurgery which do not directly intend a resection did not givegood results in either quad vitam vol functionem. Twenty of21 patients died within a relatively short time (1 to 13 months,average 3.6 months) without any functional recovery.