Abstract
The purpose of this study is to emphasise the necessity for caution in assuming the diagnosis of a metastasis when a solitary bone lesion is identified following a prior malignancy.
Bone lesions occurring in patients who have previously had a malignancy are generally assumed to be a metastasis from that malignancy. We reviewed 60 patients with a previous history of malignancy, who presented with a bone lesion that was subsequently found to be a different primary sarcoma of bone. These second malignancies occurred in three distinct groups of patients.
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Patients with original tumours well known to be associated with second malignancies (5%)
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In patients whose second malignancies were likely to be due to the previous treatment of their primary malignancy (40%)
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In patients in whom there was no clearly defined association between malignancies (55%)
Inappropriate biopsy and treatment of primary bone sarcomas compromises limb salvage surgery and can affect patient mortality. We would advise referral of any aggressive solitary bone lesion to a regional bone tumour service for further assessment and biopsy rather than to assume the lesion is a metastasis.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
