Bone Metastasis (Secondary bone tumors)

Describe the clinical setting and mode of presentation of secondary bone tumors.
What are the common primaries that metastasize to bones?
What are the common bones where metastasis is common?

The sites of metastatic cancer lesions in order of frequency:

What are the useful imaging modalities to investigate secondary bone tumor?
What are the radiological modes of presentation of secondary bone tumors in plain radiographs?
Osteoblastic lesions


Bone Metastasis

Blastic metastasis

  • Primary Cancer Prostate. .






Bone Metastasis


  • Primary Cancer .Prostate




Osteolytic lesions


Bone Metastasis

Expansile lytic rib lesions

  • Primary Lung Cancer .





Bone Metastasis

Lytic lesion right parietal bone. Bone destruction with soft tissue mass .

Mixed lesions –mixture of osteoblastic and osteolytic lesions – seen in breast cancer


Bone Metastasis

Blastic and lytic lesions

  • Primary Cancer Breast.




Pathological fracture


Bone Metastasis

Lytic lesion of humerus with a pathological fracture.

  • Primary Cancer lung.




Nerve root spinal cord compression
Pre-contrast sagittal T 1 wtd. MRI of the thoracic spine. Normal Vertebral bone marrow. Arrow points to mass Sagittal T 2 wtd. MRI

CSF is white with a grey cord

Post contrast sagittal T 1 wtd. MRI

Masss enhanced with contrast pressing on the cord

Pre contrast axial T 1 wtd. MRI

Mass compressing the cord.

Findings: Bony metastasis from renal carcinoma  involving the T 8 vertebral body, right pedicle/transverse process and spinous process (arrow in A,B,C,D) with epidural tumor producing marked degree of cord compression (red arrow).

Bone scan

Bone Metastasis / Primary Cancer Breast

Increased isotope accumulation by metastatic lesions.