Biology of Bone Metastases: Causes and Consequences

Harvey, Harold A.; Cream, Leah

doi:10.3816/cbc.2007.s.001

Cited by 40 publications

(34 citation statements)

References 45 publications

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“…Breast cancer is a highly osteotropic neoplasm. 3 On radiological examination, these metastases are predominantly osteolytic but can be osteoblastic or mixed. The mechanisms by which metastases are formed are complex, involving many steps that include angiogenesis, invasion and proliferation in the bone microenvironment.…”

Section: 2mentioning

confidence: 99%

“…There is considerable cross-talk between osteoclasts, osteoblasts, macrophages and other cellular elements within the bone environment. [3][4][5] The osteogenic sarcoma (osteosarcoma) is a malignancy of mesenchymal cells that have the ability to produce osteoid or immature bone, and usually has bimodal age distribution. Furthermore, the mandibular tumours arise more frequently in the posterior body.…”

Section: 2mentioning

confidence: 99%

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Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas

Ghosh

Wadhwa

Kumar

et al. 2011

Dentomaxillofacial Radiology

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Multiple myeloma is the prototype of malignant monoclonal gammopathies. The most common skeletal sites are pelvis, skull, spine, ribs and femoral and humeral shafts. The classic radiographic presentation of multiple myeloma is lytic skeletal lesions. Other types of presentation include sclerotic and porotic changes. Primary sclerotic manifestations are rare and occur in only 3% of cases. Although exceptional, multiple myeloma must be borne in mind in the presence of bone sclerosis. This report presents a patient with multiple myeloma with a sunburst/hair-on-end pattern on the radiograph and sclerotic skeletal lesions.

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Section: 2mentioning

confidence: 99%

Section: 2mentioning

confidence: 99%

Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas

Ghosh

Wadhwa

Kumar

et al. 2011

Dentomaxillofacial Radiology

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“…The role of osteoclasts in disease is well documented for several bone disorders, such as osteoporosis, Paget's disease, and rheumatoid arthritis (7). Over the last decade, the role of the osteoclast in metastatic disease associated with multiple myeloma (8,9), prostate cancer (10,11), or breast cancer (12)(13)(14)(15) has received considerable attention. Numerous animal and clinical studies strongly suggest the involvement of osteoclasts in enhancing the occurrence and progression of metastases in the bone microenvironment by mediating the release of factors such as interleukin (IL)-1 and transforming growth factor-β that stimulate the growth of metastatic cancer cells (10,(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Loss of Osteoclasts Contributes to Development of Osteosarcoma Pulmonary Metastases

et al. 2010

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We conducted a transcriptomic screen of osteosarcoma (OS) biopsies and found that expression of osteoclast-specific tartrate-resistant acid phosphatase 5 (ACP5/TRAP) is significantly downregulated in OS compared with nonmalignant bone (P < 0.0001). Moreover, lesions from OS patients with pulmonary metastases had 2-fold less ACP5/TRAP expression (P < 0.018) than lesions from patients without metastases. In addition, we found a direct correlation (P = 0.0166) between ACP5/TRAP expression and time to metastasis. Therefore, we examined whether metastasis-competent (MC) OS cells could induce loss of ACP5 + osteoclasts and contribute to metastasis. We found that MC OS cell lines can inhibit osteoclastogenesis in vitro and in vivo. In addition, osteoclasts can inhibit the migration of MC OS cells in vitro. Finally, ablation of osteoclasts with zoledronic acid increases the number of metastatic lung lesions in an orthotopic OS model, whereas fulvestrant treatment increases osteoclast numbers and reduces metastatic lesions. These data indicate that the metastatic potential of OS is determined early in tumor development and that loss of osteoclasts in the primary lesion enhances OS metastasis.

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“…Bone metastases and their associated complications (bone pain, pathological fractures, spinal cord compression, loss of independence and mobility and abnormal electrolytes) are the major morbidities associated with advanced disease and the symptoms with which patients will present [9] . The critical aspect in the investigation of a patient with potential metastases involves recognition of the above symptoms as possible progression of the primary tumour to bone.…”

Section: Diagnosismentioning

confidence: 99%

Orthopaedic perspective on bone metastasis

Molloy

O’Toole²

2013

WJO

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The incidence of cancer is increasing worldwide, with the advent of a myriad of new treatment options, so is the overall survival of these patients. However, from an orthopaedic perspective, there comes the challenge of treating more patients with a variety of metastatic bone lesions. The consequences of such lesions can be significant to the patient, from pain and abnormal blood results, including hypercalcemia, to pathological fracture. Given the multiple options available, the treatment of bone metastasis should be based on a patientby patient manner, as is the case with primary bone lesions. It is imperative, given the various lesion types and locations, treatment of bone metastasis should be performed in an individualised manner. We should consider the nature of the lesion, the effect of treatment on the patient and the overall outcome of our decisions. The dissemination of primary lesions to distant sites is a complex pathway involving numerous cytokines within the tumour itself and the surrounding microenvironment. To date, it is not fully understood and we still base a large section of our knowledge on Pagets historic "seed and soil" theory. As we gain further understanding of this pathway it will allow us develop more medical based treatments. The treatment of primary cancers has long been provided in a multi-disciplinary setting to achieve the best patient outcomes. This should also be true for the treatment of bone metastases. Orthopaedic surgeons should be involved in the multidisciplinary treatment of such patients given that there are a variety of both surgical fixation methods and non-operative methods at our disposal. MINIREVIEWS© 2013 Baishideng. All rights reserved.Key words: Bone metastases; Diagnosis; Pathophysiology; Surgical treatment, Medical treatment Core tip: This paper discusses the pathophysiology and patient implications of bone metastasis. We aim to describe the orthopaedic input into the management of this condition, especially in a multi-disciplinary setting. We believe that orthopaedics do not have a significant enough involvement in the treatment of long bone metastasis, although from this paper we feel we have many options to offer. The future of metastasis treatment may be targeted at the molecular level but current management options do require an understanding of musculoskeletal oncology to obtain best patient outcomes through operative and non-operative means.Molloy AP, O'Toole GC. Orthopaedic perspective on bone metastasis. World

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Biology of Bone Metastases: Causes and Consequences

Cited by 40 publications

References 45 publications

Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas

Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas

Loss of Osteoclasts Contributes to Development of Osteosarcoma Pulmonary Metastases

Orthopaedic perspective on bone metastasis

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