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Lytic Osseous Metastases
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Osteolytic metastases
            • Definitions

              • Spread of primary tumor to spine, where bone destruction exceeds bone production

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Kaloostian PE et al: Current paradigms for metastatic spinal disease: an evidence-based review. Ann Surg Oncol. 21(1):248-62, 2014
                                              2. Molina CA et al: Diagnosis and management of metastatic cervical spine tumors. Orthop Clin North Am. 43(1):75-87, viii-ix, 2012
                                              3. Quraishi NA et al: Management of metastatic sacral tumours. Eur Spine J. 21(10):1984-93, 2012
                                              4. Heran MK: Preoperative embolization of spinal metastatic disease: rationale and technical considerations. Semin Musculoskelet Radiol. 15(2):135-42, 2011
                                              5. Munk PL et al: Fire and ice: percutaneous ablative therapies and cement injection in management of metastatic disease of the spine. Semin Musculoskelet Radiol. 15(2):125-34, 2011
                                              6. Fehlings MG et al: Decision making in the surgical treatment of cervical spine metastases. Spine (Phila Pa 1976). 34(22 Suppl):S108-17, 2009
                                              7. Guillevin R et al: Spine metastasis imaging: review of the literature. J Neuroradiol. 34(5):311-21, 2007
                                              8. Kubota T et al: High-resolution imaging of the spine using multidetector-row computed tomography: differentiation between benign and malignant vertebral compression fractures. J Comput Assist Tomogr. 29(5):712-9, 2005
                                              9. Tokuhashi Y et al: A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 30(19):2186-91, 2005
                                              10. Aebi M: Spinal metastasis in the elderly. Eur Spine J. 12 Suppl 2:S202-13, 2003
                                              11. Chang EL et al: Diagnosis and management of central nervous system metastases from breast cancer. Oncologist. 8(5):398-410, 2003
                                              12. Lipton A: Bone metastases in breast cancer. Curr Treat Options Oncol. 4(2):151-8, 2003
                                              13. Tomita K et al: Surgical strategy for spinal metastases. Spine. 26(3):298-306, 2001
                                              14. Castillo M et al: Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR Am J Neuroradiol. 21(5):948-53, 2000
                                              15. Murphy KJ et al: Percutaneous vertebroplasty in benign and malignant disease. Neuroimaging Clin N Am. 10(3):535-45, 2000
                                              16. Wetzel FT et al: Management of metastatic disease of the spine. Orthop Clin North Am. 31(4):611-21, 2000
                                              17. Chamberlain MC et al: Epidural spinal cord compression: a single institution's retrospective experience. Neuro Oncol. 1(2):120-3, 1999
                                              18. Cook AM et al: Magnetic resonance imaging of the whole spine in suspected malignant spinal cord compression: impact on management. Clin Oncol (R Coll Radiol). 10(1):39-43, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Osteolytic metastases
                                                        • Definitions

                                                          • Spread of primary tumor to spine, where bone destruction exceeds bone production

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Nonvascular Interventions

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Kaloostian PE et al: Current paradigms for metastatic spinal disease: an evidence-based review. Ann Surg Oncol. 21(1):248-62, 2014
                                                                                          2. Molina CA et al: Diagnosis and management of metastatic cervical spine tumors. Orthop Clin North Am. 43(1):75-87, viii-ix, 2012
                                                                                          3. Quraishi NA et al: Management of metastatic sacral tumours. Eur Spine J. 21(10):1984-93, 2012
                                                                                          4. Heran MK: Preoperative embolization of spinal metastatic disease: rationale and technical considerations. Semin Musculoskelet Radiol. 15(2):135-42, 2011
                                                                                          5. Munk PL et al: Fire and ice: percutaneous ablative therapies and cement injection in management of metastatic disease of the spine. Semin Musculoskelet Radiol. 15(2):125-34, 2011
                                                                                          6. Fehlings MG et al: Decision making in the surgical treatment of cervical spine metastases. Spine (Phila Pa 1976). 34(22 Suppl):S108-17, 2009
                                                                                          7. Guillevin R et al: Spine metastasis imaging: review of the literature. J Neuroradiol. 34(5):311-21, 2007
                                                                                          8. Kubota T et al: High-resolution imaging of the spine using multidetector-row computed tomography: differentiation between benign and malignant vertebral compression fractures. J Comput Assist Tomogr. 29(5):712-9, 2005
                                                                                          9. Tokuhashi Y et al: A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 30(19):2186-91, 2005
                                                                                          10. Aebi M: Spinal metastasis in the elderly. Eur Spine J. 12 Suppl 2:S202-13, 2003
                                                                                          11. Chang EL et al: Diagnosis and management of central nervous system metastases from breast cancer. Oncologist. 8(5):398-410, 2003
                                                                                          12. Lipton A: Bone metastases in breast cancer. Curr Treat Options Oncol. 4(2):151-8, 2003
                                                                                          13. Tomita K et al: Surgical strategy for spinal metastases. Spine. 26(3):298-306, 2001
                                                                                          14. Castillo M et al: Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR Am J Neuroradiol. 21(5):948-53, 2000
                                                                                          15. Murphy KJ et al: Percutaneous vertebroplasty in benign and malignant disease. Neuroimaging Clin N Am. 10(3):535-45, 2000
                                                                                          16. Wetzel FT et al: Management of metastatic disease of the spine. Orthop Clin North Am. 31(4):611-21, 2000
                                                                                          17. Chamberlain MC et al: Epidural spinal cord compression: a single institution's retrospective experience. Neuro Oncol. 1(2):120-3, 1999
                                                                                          18. Cook AM et al: Magnetic resonance imaging of the whole spine in suspected malignant spinal cord compression: impact on management. Clin Oncol (R Coll Radiol). 10(1):39-43, 1998