Clinical Observation on Metastatic Bone Cancers

Clinical observation on 22 cases of metastatic bone tumors was done at the department of orthopaedic surgery, Pusan National University Hospital from February. 1958 to August, 1965. The results were as follows; 1. Among 22 cases of metastatic bone cancers, renal cell cancer was 9 cases (40.9%), prostatic cancer was 5 cases(22.7%), hepatoma was 4 cases(18.2%), breast cancer was 3 cases(13.6%) and lung cancer was 1 case(4.6%). 2. Reports in the literature concerning the incidences of the primary lesions were cited. 3. In metastatic bone cancers, 86.3 per cent were between 40 and 69 years of age, and the average age was 53.3 years. 4. Ratio between male and female was 2.7:1. 5. The bones, affected most frequently in this series were as following; a. Femur 13 cases(29.6%) b. Pelvic bone 10 cases(22.7%) c. Ribs 5 cases(11.4%) d. Humerus 4 cases(9.1%) e. Thoracic vertebrae 3 cases(6.8%) f. Lumbar vertebrae 3 cases(6.8%) g. Clavicle 2 cases(4.2%) h. Scapula 2 cases(4.5%) i. Skull 1 case(2.3%) j. Tibia 1 case (2.3%) Single bony lesion was seen in 15 cases (68.3%) and multiple bony lesions in 7 cases(32.7%). 6. The average interval between first complaints and admittion for bony lesions was 3 months and 24 days. 7. Clinical features in this series were classified accordings to various conditions. Pain and tenderness was 22 cases(100%) and its noticed most commonly. 8. Pathologic fractures occured on 10 cases in this series. Among them, the femur was 9 cases (9%) and the clavicle was case(10%). 9. Hematologically, anemia and elevated S.R. was noticed in all cases. Serum alkaline phosphatase was elevated (average 18.6 S-J Unit.),and serum acid phosphatase was elevated in prostatic cancers. Serum calcium was elevated in all cases (average 11.5mg%) 10. In roentgenographic evidence, were osteolytic in 17 casea (77.3%), osteoplastic in 3 cases (13.6%), and mixed type in 2 cases(9.1%). 11. All cases was treated by conservative and chemotherapy. Among in this series, amputatted in 1 case. hip spica cast in 5 cases and open reduction in 1 case. 12 In this series, death occured in 17 cases within 12 months and the other 5 cases was not followed.