Morphological Findings in Bone Metastasis, Tumorosteopathy and Antiosteolytic Therapy

Bone metastases are an important complication of malignant disease as the skeleton is the third most common site of metastases after the filter organs lung and liver. Bone metastases are in fact metastases of the bone marrow, and the term bone metastasis — although it has been used since the beginning of clinical interest in this subject — is therefore incorrect. The tumor cells growing in the bone marrow can disturb skeletal and calcium homeostasis and cause structural and compositional alterations of the bone tissue termed tumor osteopathy or osteopathy of malignancy. Due to the associated bone pain, pathological fractures, and hypercalcemia, metastases to bone can considerably influence the course and prognosis of a neoplastic disease. As metastases to bone are the expression of hematogenous dissemination the detection of osseous metastases means that curative therapy of malignancy is no longer possible. Osseous metastases are therefore generally considered a sign of prognostic deterioration of the malignant disease, although cases with osseous metastases alone are associated with longer survival times than those with extraosseous metastases (Wander 1986). Bone metastases are not responsible for cancer mortality but rather but cancer morbidity.