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Unusual and early aspects of bone metastasis

par Matelart, A.L.;Osteaux, Michel Jean ;De Wilde, Annie ;Jeanmart, Louis
Référence Journal belge de radiologie, 62, 1, page (35-40)
Publication Publié, 1978

Article révisé par les pairs

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Résumé :

The importance of early detection of bone metastasis can not be disputed: the institution of adequate treatment depends on precise knowledge of the stage of the neoplastic condition. The skeletal scintigram, a sensitive early detection method, does not permit diagnosis of the etiology: X-ray techniques are most often used to confirm metastasis. Therefore, judicious detection and interpretation of X-ray signs at the onset are of fundamental importance. The review of 352 X-ray files on the evolution of neoplasms in confirmed cases of bone generalization has led the authors to elucidate the early and unusual aspects of metastatic infiltrations. These aspects are: small punched-out lesions, evidence of the onset of osteolysis, slight alterations in the trabeculation, giving the affected region a fine pebbly appearance, unusual localizations, unusual characteristics in relation to the primary tumor, a significant periosteal reaction, vertebral compaction with a particular appearance. It has been established that these various aspects are much more frequently encountered than the traditional signs: about 50% in the authors' material. It is possible to make more precise diagnoses in suspected cases by using computed tomography, especially in detecting monocortical metastasis in the pelvis and in precisely defining the extent into soft tissue.