musculoskeletal and connective tissue disorders
Metastatic Bone Tumors
Key Points
Carcinomas of breast, lung, prostate, and kidney are the most common sources of metastatic bone tumors. Bone metastases should be suspected in patients with known cancer, when pain is at more than one site, and/or when findings on imaging studies suggest metastases. Bone biopsy is needed if the primary tumor is unknown after clinical and radiographic evaluation. Patients with known solid organ cancer and limited bone lesions may require a needle biopsy to confirm metastatic disease and exclude a second primary tumor. Most often, radiation therapy, bisphosphonates, and RANKL inhibitors (denosumab) are used to slow bone destruction. Pathologic fractures may require treatment with surgery, kyphoplasty, or vertebraplasty. 