Correlation between new bone lesions and primary tumors in patients with a single known malignancy for90 cases of biopsy
ZHANG Liang
CHEN Zi-xian
WANG Yi-chao
GU Yu-tong
Abstract：Objective Suspected bone lesions may often be found during the follow-up of malignant tumor patients. But not all of them are associated with primary tumors. Bone biopsy aids in the definitive diagnosis and avoiding improper treatment. The aim of this study is to investigate the probability of alternative diagnoses of benign or malignant tumors via bone biopsy of newly found bone lesions, as well as to analyze the clinical factors that affect the correlation between bone lesions and primary tumors, in order to provide the basis for the decision-making of biopsy of new bone lesions in malignant tumor patients. Methods We retrospectively studied the data of patients with a single known malignancy who received biopsy of newly found bone lesions at our institution between 2012 and 2016. According to the pathological results, all cases were divided into bone-metastasis-of-primary-tumor group and non-bone-metastasis-of-primary-tumor group. We reviewed each patient's age, gender, clinical symptoms ( such as pain and neurological deficit ), 18F-FDG PET / CT or ECT records, pathological results, the number of involved bones ( single or multiple ), the sites of bone biopsy and the interval between the diagnosis of primary tumor and that of the bone lesion. The clinical factors that might affect the correlation between bone lesions and primary tumors were analyzed. Results A total of 90 malignant tumor patients with an average age of ( 56.9 ± 12.8 ) years had underwent bone biopsy, including 49 males and 41 females. Pathologic results of bone biopsy showed as follow: 16.7％ ( 15 / 90 ) of the bone lesions were benign, including simple bone cyst, aneurismal bone cyst, fibrous dysplasia, tuberculosis and solitary fibrous tissue tumor ( n = 1 each ), etc. 2.2％ ( 2 / 90 ) were due to a second malignancy, consisting of chondrosarcoma ( n = 1 ) and metastasis of another carcinoma ( n = 1 ); 81.1％ ( 73 / 90 ) were confirmed as bone metastases of primary tumors. 85.0％ ( 68 / 80 ) of cases with clinical symptoms were diagnosed as bone mateastases of primary tumor, significantly higher than the rate of asymptomatic cases ( 50.0％, 5 / 10 ) ( P = 0.017 ). There were no significant differences in the age, gender, interval between the diagnosis of primary tumor and that of the bone lesion, or PET / CT SUVmax between the two groups. Both of the number and location of bone lesions were not the factors affecting the correlation of bone lesions and primary tumors. Conclusions Approximately 20％ of newly found bone lesions in patients with a single known malignancy have nothing to do with primary tumors, and 2.2％ of which are newly discovered malignant bone tumors. The clinical symptom is an important factor affecting the correlation between bone lesions and primary malignancies. For newly found bone lesions in patients with malignant tumor during the follow-up, especially without clinical symptoms, bone biopsy should be suggested to confirm the diagnosis and to avoid misdiagnosis and inadequate treatment.
Keywords：Bone neoplasmsNeoplasmsmultiple primaryNeoplasm metastasis
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 20-24 )