Osteolytic cortical destruction: an unusual pattern of skeletal metastases

Abstract

Twenty-two histologically proven cortical metastases in 11 patients with bronchogenic carcinoma (10 squamous cell and one adenocarcinoma) were studied. The intracortical foci could be classified according to four distinctive patterns of bone destruction: small focal intracortical lesions ("cookie-bite" or "cookie-cutter" pattern); large osteolytic lesions; saucerized intracortical lesions with well-defined periosteal reaction; and lesions with predominant cortical destruction extending into the soft tissue as well as the medullary cavity. All lesions were located in the femoral bones.

Cortical metastatic lesions of the appendicular skeleton from tumors of known primary origin

“…Each specimen was subject to cytologic and/or histopathologic examination, the results of which were in agreement with an identified primary tumor. Predominantly cortical destruction extending into the soft tissues as well as the medullary cavity (9 lesions) *According to classification of Greenspan and Norman [7]. …”

“…Lesions in which osseous destruction was predominantly cortical were categorized according to the classification proposed by Greenspan and Norman [7]. This scheme includes four types of cortical lesions (Table I): type I-small focal lesions or marginal cortical destruction (Fig.…”

“…In fact, only one non-appendicular site, a single skull lesion, has been cited [4]. The origin of these lesions, however, has been debated; the majority of earlier studies report pulmonary tumors to be chiefly, if not solely, responsible [4][5][6][7], whereas more recent studies have suggested that many different types of tumors have the capacity to metastasize to the cortex of bone [8,9].…”

Needle Aspiration of Extrathoracic Metastases from Bronchogenic Carcinoma

“…However, lesions may have predominantly cortical destruction with extension into the soft tissue. 5 The spread of the tumor beyond the bone into the soft tissue accounts for the ease of diagnosis by needle aspiration in the first three case reports.…”

Unusual bone metastasis from follicular carcinoma thyroid: presenting as a primary bone malignancy

“…In most cases, however, the organ of origin of the metastasis cannot be determined by histological examination. 4 Bone metastasis is purely lytic, blastic, and mixed. Bone metastasis is purely lytic as found in liver, breast and thyroid.…”