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Multiple myeloma
9%
235/2547
Post-radiation sarcoma
0%
12/2547
Metastatic bone disease
87%
2228/2547
Paget's sarcoma
1%
19/2547
Lymphoma
2%
48/2547
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The following malignant bone tumors occur most frequently in patients 40-80-years old (in order of decreasing frequency): metastatic bone disease, myeloma, lymphoma, Paget's sarcoma, and post-radiation sarcoma. The skeleton is a common site for metastasis from several visceral carcinomas. Think BLTPK for sources of metastasis: breast, lung, thyroid, prostate, and kidney. The cited article by Rougraff et al recommends a work-up that includes a history and physical examination, routine laboratory analysis, plain radiography of the involved bone and the chest, whole-body bone scan, and computed tomography of the chest, abdomen, and pelvis. These should all be performed prior to biopsy. Using this diagnostic strategy they were able to identify the primary site of cancer in 85% of patients in their study.
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