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Bone Metastasis The lung is the largest filter in our body, through which all circulation passes and therefore any metastatic embolus that reaches the venous circulation has a high probability of suffering stasis in the lung and developing metastatic lesions. This is why the lung is the biggest site for metastases in our body. The liver represents a filter for the digestive system, which through the portal circulation can receive metastatic emboli from that system.

Bone Metastasis

    Skeletal tissue represents the third major filter, which, due to its slow sinusoidal circulation, favors the shelter of metastatic emboli that may reach the bone.

         Currently, with the increase in the survival of patients with different neoplasms, resulting from increasingly earlier diagnoses, advances in chemotherapy with a variety of increasingly effective drugs and the control of side effects, the number of patients who have their primitive disease controlled and that metastasize to the skeleton is increasing.

         The tumors that most frequently produce bone metastases are breast carcinoma in women, prostate carcinoma in men, and lung carcinoma. kidney and thyroid in both.

         The bone injuries that most frequently give clinical manifestations, requiring orthopedic surgery, occur in the femur, humerus, vertebrae, pelvis, scapula and tibia, in that order.

         The natural history of this condition is painful and the diagnosis can generally occur due to a pathological bone fracture that causes functional impotence, limitations in activities of daily living, dependence on others, bedsores and multiple organ failure due to the patient being bedridden.

         The role of the oncology orthopedist aims to operate on the metastatic lesion as early as possible in order to alleviate pain, restore function and improve the patient’s quality of life.

         For this purpose, resection and reconstruction surgeries are performed using osteosyntheses with cement or endoprostheses.

         Radiotherapy can eventually be used as a palliative measure, aiming to relieve pain for patients who are not clinically fit for surgery. 

         In relation to multiple myeloma, which is the most common primitive tumor of the bone, a tumor of the SRE, we must add that it is treated with chemotherapy and is also highly sensitive to radiotherapy. However, in cases that develop significant bone injuries or risk of fracture, orthopedic surgical management is similar to the treatment of bone metastases.

Click here to download PDF article on male breast tumor metastasis.

Click here to see hypernephroma metastasis treatment.

Author: Prof. Dr. Pedro Péricles Ribeiro Baptista

 Orthopedic Oncosurgery at the Dr. Arnaldo Vieira de Carvalho Cancer Institute

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