Biopsy of suspicious bone lesions in patients with a single known malignancy: Prevalence of a second malignancy Journal Article


Authors: Raphael, B.; Hwang, S.; Lefkowitz, R. A.; Landa, J.; Sohn, M.; Panicek, D. M.
Article Title: Biopsy of suspicious bone lesions in patients with a single known malignancy: Prevalence of a second malignancy
Abstract: OBJECTIVE. The probability that a suspicious bone lesion in a patient with one known malignancy is actually due to a second, previously unknown primary malignancy has been reported to be 2-8%. We sought to determine this prevalence as well as that of benign diagnoses in a larger number of patients in a tertiary cancer center. MATERIALS AND METHODS. The medical records of 482 consecutive patients (254 women and 228 men) with only one known primary malignancy each (excluding nonmelanoma skin cancer) and who underwent biopsy of a suspicious bone lesion were retrospectively reviewed. The results of bone biopsy were classified as benign, metastasis of the known primary malignancy, due to a second primary malignancy, or nondiagnostic or indeterminate. RESULTS. In 103 of 482 (21%) patients, bone biopsy results were benign, 316 (66%) were due to metastases of the known malignancy, 15 (3%) were due to a second malignancy, and 48 (10%) were nondiagnostic or indeterminate. Second malignancies included osteosarcoma (n = 4); soft-tissue sarcoma (n = 2); lymphoma (n = 2); plasma cell malignancy (n = 2); and lung cancer, thyroid cancer, renal cancer, chondrosarcoma, and carcinoma of unknown primary (n = 1 each). CONCLUSION. In 3% of patients with one known malignancy and a suspicious bone lesion, the lesion was due to a previously unknown second malignancy; in 21% of patients, the lesion was benign. Bone biopsy is recommended in the management of patients with one known cancer and a suspicious bone lesion only if the presence of a second malignancy would alter clinical management.
Keywords: bone metastasis; biopsy; second cancer; cancer
Journal Title: American Journal of Roentgenology
Volume: 201
Issue: 6
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2013-12-01
Start Page: 1309
End Page: 1314
Language: English
DOI: 10.2214/ajr.12.10261
PROVIDER: scopus
PUBMED: 24261372
DOI/URL:
Notes: Export Date: 2 January 2014 -- CODEN: AJROA -- Source: Scopus
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MSK Authors
  1. David M Panicek
    134 Panicek
  2. Jonathan Landa
    37 Landa
  3. Sinchun Hwang
    96 Hwang
  4. Michael J Sohn
    13 Sohn