Bony metastases

Differential Diagnosis

• Osteoblastic (sclerotic) lesions, with deposition of new bone
  • Prostate cancer
  • Carcinoid tumour
  • Small cell lung cancer
  • Hodgkin lymphoma
  • Medulloblastoma
• Osteolytic lesions, with destruction of normal bone
  • Renal cell carcinoma
  • Melanoma
  • Multiple myeloma
  • Thyroid cancer
  • Non-Hodgkin lymphoma
  • Non-small cell lung cancer
  • Langerhans cell histiocytosis
  • Non-malignant causes of lytic bone lesions
• Mixed lesions
  • Breast cancer, though it is predominantly osteolytic
  • Colorectal cancer and other gastrointestinal cancers
  • Squamous cell cancer

Management

• Denosumab at high dose
• Bisphosphonate

Further Reading

• Bone Metastases: An Overview. Oncol Rev. 2017 Mar 3; 11(1): 321. doi: 10.4081/oncol.2017.321