Malignant Bone Tumors: Pathogenesis of X-ray appearance
• Metastatic bone tumors (aka. cancerous cells from systemic locations that metastasized to the bone) are 200 times more common than primary bone tumors.
• Metastatic bone tumors can often look differently from primary bone tumors on X-ray, depending on the source of metastasis:
• Breast. prostate cancer bone metastases are often "radio-dense" (sclerotic lesions that look whiter than normal bone) - these cancer cells activate osteoblasts more than osteoclasts.
• Lung. thvroid. and renal cancer bone metastases are often "radio-lucent" (osteolytic lesions that look darker than normal bone) - these cancer cells activate largely osteoclasts.
• "Interrupted periosteal reaction '
• "Moth-eaten", permeative bone destruction
• Wide zone of transition between bone and tumor (Ill-defined border)
• Soft-tissue mass accumulation around the bone tumor
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