-2 :: Case - 13902 :: - Breast Cancer, Metastatic to orbit and brain
Medical Image Database, Atlas, and Teaching File
All Cases are Peer Reviewed by an Editoral Panel

Tx and Followup:
Pending

Additional Discussion:
This woman was known to have metastatic breast cancer, prior to this admission.

Discussion Author: Miriam N Mikhail

Breast cancer remains the leading cause of death in women in the 40-44 age group. Breast metastases to bone are generally blastic, but can be lytic or mixed lytic/blastic. Patients with skeletal mets most commonly present with bone pain (70%), followed by the vague constellation of symptoms due to hypercalcemia (fatigue, depression, confusion, anorexia, nausea, constipation, renal tubule defects, polyuria, or short QT interval). Breast cancer is the second-most common neoplasm to cause release of PTHrp (following non-small cell lung cancer); hence, breast metastases do not uncommonly cause hypercalcemia, and usually NOT from local osteolysis. Of patients with metastatic disease to the skeleton and hypercalcemia, 80% of the cases of hypercalcemia are due to PTHrP but only 20% due to local osteolysis.

If a patient with skeletal metastases presents with acute neurologic impairment, a vertebral body lesion compressing the spinal cord may be found - 'spinal syndrome'; this is an indication for IMMEDIATE local irradiation (even in the middle of the night) and massive intravenous steroid therapy.

Note that 30-50% of bone has to be removed by a lytic lesion prior to becoming a conspicuous lucency on plain films!!!

Topic Details: Breast Cancer, Metastatic :: :: Search for other Topics with Breast Cancer, Metastatic

Highlight this =>[ Breast Cancer, Metastatic ]<= for a Popup Search Tool