Key Clinical Features of Metastases

1. Age:

   1. Most patients presenting with skeletal metastases are in their second half of life, M/C past the 4^th decade

   2. Children <5 id="xmfe221">Neuroblastoma

   3. 10-20 yoa caused by Ewing’s sarcoma and Osteosarcoma

   4. 20-35 yoa casued by Hodgkin’s lyphoma

2. Appearance at presentation:

   1. Most patients present with a history of recent weight loss, appear cachectic, and experience anemia and fever in advanced stages of the disease

   2. Secondary skeletal deposits create the first symptoms of the carcinomatous process. Common w/ carcinoma of the thyroid, liver, and kidney

   3. Sign and symptoms are pain and pathologic fracture. Pain is insidious onset w/ bouts of remission and exacerbation.

3. Key laboratory Findings

   1. Elevated erythrocyte sedimentation rate (ESR) is often present but not pathognomic of metastatic disease

   2. Elevation of serum calcium may occur in diffuse osteolytic metastatic carcinoma. Serurm calcium in most cases, even if lytic, are normal.

   3. Alkaline phosphatase is frequently elevated in blastic metastaic lesions but overall is a insensitive indicator of bone metastasis.

   4. Prostate Specific Antigen (PSA) is elevated >10ng/mL in cancer patients which the prostate gland tumor has broken through

Category: Tumors Revision