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Bone Metastasis

Metastatic Neoplasm to the Bone Marrow


Presentation

  • Moreover, the patients who have bone metastasis at presentation are even rare.[ncbi.nlm.nih.gov]
Fatigue
  • A 30-year-old male was admitted to our hospital with a complaint of abdominal distension, fatigue, and anorexia for 2 months.[ncbi.nlm.nih.gov]
  • Cancer Related Fatigue When it comes to cancer-related fatigue, this affects up to 80% to 90% of persons with cancer. It is more severe than what we refer to as general fatigue when people sort of say, “I’m tired,” but it’s not the same.[melioguide.com]
  • Signs of hypercalcemia include fatigue, rash, weakness and weight loss. How Are Metastatic Bone Lesions Found? They may be discovered as a result of an investigation into a new onset of pain, paralysis or other symptoms.[cancerliving.today]
  • Patients during/after RT often suffer from the RT‐related toxicities including radiation sickness, fatigue, nausea, vomiting, mucous membrane disorder, etc.[intechopen.com]
  • Bone pain that is worse at night Discomfort when you walk or sit, or trouble finding a comfortable position Fatigue or weakness Bone fractures Numb area, trouble moving a body part, or trouble urinating Weight loss without trying, or loss of appetite[drugs.com]
Localized Pain
  • We report the case of an 11-year-old boy who came to our observation with localized pain in the left arm for nearly 5 months. No previous history of trauma was referred in an otherwise healthy patient.[ncbi.nlm.nih.gov]
  • Radiation therapy can help to relieve localized pain due to bone metastasis. It is delivered via various means.[cancerliving.today]
  • Local pain usually precedes radicular pain and may predate the appearance of other neurologic signs by weeks or months. Most patients with spinal cord compression will have weakness or paralysis.[doi.org]
Plethora
  • The plethora of ongoing clinical trials will hopefully translate into improved treatments options for patients suffering from bone metastatic cancers.[ncbi.nlm.nih.gov]
  • Osteoblasts synthesize a plethora of biologically active factors, which comprise the unique bone microenvironment.[kluedo.ub.uni-kl.de]
Refractory Anemia
  • He had a history of myelodysplastic syndrome and refractory anemia with ringed sideroblasts diagnosed 5 years earlier.[ncbi.nlm.nih.gov]
Nausea
  • Oxycodone was also administered but discontinued due to nausea.[ncbi.nlm.nih.gov]
  • When it does occur, signs and symptoms of bone metastasis include: Bone pain Broken bones Urinary incontinence Bowel incontinence Weakness in the legs or arms High levels of calcium in the blood (hypercalcemia), which can cause nausea, vomiting, constipation[mayoclinic.org]
  • High blood levels of calcium can lead to other problems such as loss of appetite, excessive thirst, nausea and constipation. As the cancer dissolves the bone, it breaks easily.[novartis.com]
Abdominal Pain
  • Case 2: Clinical history A 48 year-old white woman presented with a four-week history of left lower quadrant abdominal pain.[bmcclinpathol.biomedcentral.com]
  • High calcium can cause constipation, which can result in abdominal pain, and with very high calcium levels, confusion and mental status changes can occur.[oncolink.org]
  • Metastatic disease to the liver causes jaundice, elevated liver enzymes, abdominal pain, loss of appetite, nausea, and vomiting. Metastatic breast cancer to the lung or pleura causes chronic cough, dyspnea, abnormal chest x-ray, and chest pain.[breast-cancer.ca]
Hemorrhagic Bullae
  • Left ear showed large hemorrhagic bullae on the posterior segment of tympanic membrane. Left sided facial paralysis developed on the third day of admission. Full recovery of facial paralysis is achieved by 10 days course of corticotherapy.[ncbi.nlm.nih.gov]
Diplopia
  • She was then followed in the surgery clinic, and 2 months after surgery, she visited an emergency room complaining of headache and diplopia. Neurological examination showed the left IV, V1, and VI cranial nerve palsies.[ncbi.nlm.nih.gov]
Back Pain
  • Non-steroidal anti-inflammatory drugs and zoledronic acid were administered for back pain. Oxycodone was also administered but discontinued due to nausea.[ncbi.nlm.nih.gov]
  • CHATZIIOANNOU, Pancreatic cancer's initial presentation: back pain due to osteoblastic bone metastasis, European Journal of Cancer Care, 19, 1, (137), (2010). M. Beheshti, C. Pirich and W.[doi.org]
Low Back Pain
  • The patient developed low back pain due to unknown etiology, 3 months after surgery. A follow-up 18F-FDG PET/CT scan demonstrated multifocal bone destruction. Unfortunately, the patient died 12 months after surgery.[ncbi.nlm.nih.gov]
  • MRI T2W sagittal image showing (a) metastasis with cord compression (prostate) [4] Differential Diagnosis Multiple Myeloma Infection Primary sarcoma Arthritis Low Back Pain Traumatic Fracture Aetiology Metastatic bone cancer starts with a tumor within[physio-pedia.com]
Sternoclavicular Joint Pain
  • A 73-year-old man complained of sternoclavicular joint pain; blood tests revealed elevated C-reactive protein. The patient developed delirium; magnetic resonance imaging showed metastatic bone tumors. He died two weeks after admission.[ncbi.nlm.nih.gov]
Neck Mass
  • The authors report a unique case of occult prostate cancer that presented with an anterior midline neck mass diagnosed as a thyroglossal duct cyst.[ncbi.nlm.nih.gov]
Insomnia
  • The EORTC QLQ-C30 scale at 1 month demonstrated significant improvement (P 0.05) in the physical (P 0.03) and emotion function (P 0.003), global health status (P 0.002), pain (P 0.001) and insomnia (P 0.002).[ncbi.nlm.nih.gov]

Workup

  • Endometrial biopsy should be included in the patient's workup when investigating for metastatic bone adenocarcinoma of unknown origin, even when gynaecological symptoms are lacking, as this rare presentation of stage IVb endometrial cancer appears to[ncbi.nlm.nih.gov]
  • In selected patients with metastatic disease of the spine, the following diagnostic procedures may be performed: Percutaneous core needle biopsy Open biopsy See Workup for more detail.[emedicine.medscape.com]
  • Pretreatment Workup Before bone radiofrequency ablation, all patients underwent a routine physical examination, laboratory tests, and diagnostic imaging studies.[doi.org]
Calcitonin Increased
  • Shah, Calcitonin increases invasiveness of prostate cancer cells: Role for cyclic AMP‐dependent protein kinase A in calcitonin action, International Journal of Cancer, 117, 4, (551-560), (2005).[doi.org]
Bone Marrow with Tumor Cells
  • For histologic tissue sections, bone is stained green, whereas bone marrow and tumor cells (asterisk) are stained red. (E) Fluorescence analyses of B02-GFP/βGal tumor cells residing in bone. Arrows indicate fluorescent tumor cells.[ncbi.nlm.nih.gov]
Hypercellular Bone Marrow
  • The pathological findings of resected rib bones exhibited hypercellular bone marrow without excess of blasts.[ncbi.nlm.nih.gov]

Treatment

  • After initiating cancer treatment for bone metastasis, it is not uncommon to observe transient asynchronous accumulation in bone scintigraphy or transient increases in ALP in patients who ultimately respond to the treatment.[ncbi.nlm.nih.gov]
  • The goals of the treatment for bone metastases include pain control, prevention and treatment of fractures, maintenance of patient function, and local tumor control.[en.wikipedia.org]

Prognosis

  • In this study, we aim to investigate the incidence and clinicopathological features and to evaluate the prognosis of TNBC patients with BM.[ncbi.nlm.nih.gov]

Etiology

  • The patient developed low back pain due to unknown etiology, 3 months after surgery. A follow-up 18F-FDG PET/CT scan demonstrated multifocal bone destruction. Unfortunately, the patient died 12 months after surgery.[ncbi.nlm.nih.gov]
  • In this new 8th edition an outstanding editorial team from world-renowned medical centers continues to hone the leading edge forged in previous editions, with timely information on biology, immunology, etiology, epidemiology, prevention, screening, pathology[books.google.de]
  • (See Pathophysiology and Etiology ) Pathophysiology and Etiology Previously, the two main theories of how tumor cells metastasize and grow in bones were Paget's fertile soil hypothesis and Ewing's circulation theory.[emedicine.medscape.com]
  • Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. Pain. 2001; 93 247-257 9 Goetz M P, Callstrom M R, Charboneau J W et al..[doi.org]

Epidemiology

  • Claude Jasmin, Rodolfo Capanna, Lawrence Coia, Robert Coleman, Gerard Saillant Wiley, 11.03.2005 - 582 Seiten The epidemiological and clinical importance of bone metastases has long been recognised.[books.google.de]
  • Overview of the epidemiology, clinical presentation, diagnosis, and management of adult patients with bone metastasis. . Accessed Jan. 2, 2015. Longo DL, et al. Harrison's Principles of Internal Medicine. 18th ed.[mayoclinic.org]
  • Despite the growing literature on breakthrough pain, there are still many aspects yet to be addressed including an urgent need to standardize terminology, for carefully designed epidemiological studies and for well designed controlled trials comparing[doi.org]
  • Besides describing incidence, epidemiology and clinical consequences of bone metastases and cancer treatment-induced fractures, the guideline provides recommendations in: diagnosis of bone metastases, multidisciplinary management of bone metastases in[esmo.org]
Sex distribution
Age distribution

Pathophysiology

  • Recent findings Bone pain has been shown to have a unique pathophysiology.[doi.org]
  • The pathophysiology of bone metastasis is poorly understood.[ncbi.nlm.nih.gov]
  • (See Pathophysiology and Etiology ) Pathophysiology and Etiology Previously, the two main theories of how tumor cells metastasize and grow in bones were Paget's fertile soil hypothesis and Ewing's circulation theory.[emedicine.medscape.com]

Prevention

  • Nurses play a vital role in the patient treatment plan by implementing interventions that promote positive outcomes and prevent injuries.[ncbi.nlm.nih.gov]

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