The presence or absence of metastases is the major factor related to both prognosis and surgical planning. In sarcomas the common route of hematogenous metastasis is to the lung and the less common regional metastasis to lymph nodes has the same ominous prognostic significance. They indicate the failure of local control, and the presence of either indicates little chance for prolonged survival.
Carcinoma gives rise to bone metastasis especially from cancer breast, prostate, lung, thyroid, kidney and lastly the gastro-intestinal tract carcinomas, usually presented by pathological fracture, or multiple bone secondries.
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Multiple bone secondries with pathological fracture of the proximal humerus and neck femur |
Bone scan showing multiple areas of increased tracer uptake on the sternum, ribs, pelvis and long bone |
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Bone scan showing multiple areas of increased tracer uptake on the sternum, ribs, pelvis and long bone |