The Impact of Lung Carcinoma Histology on the Frequency of Bone Metastases

Diagnosis of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer

PURPOSE

To study the clinical diagnostic value of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer.

METHODS

The clinical data of 120 patients consistent with pulmonary cancer admitted to the First Affiliated Hospital of Hebei North University from March 2019 to December 2019 were selected for retrospective analysis, and they were divided into the bone metastasis group (n = 58) and non-bone metastasis group (n = 62) according to comprehensive evaluation result of X-ray, CT, MRI and clinical follow-up. The CT values of patients were obtained by SPECT/CT bone imaging to compare serum levels of ALP (alkaline phosphatase belongs to phosphoric monoester hydrolases, as a specific phosphatase, mainly in body tissues and body fluid) and BAP (bone alkaline phosphatase is formed by different modification and processing of alkaline phosphatase, and is mainly released by osteoblasts) and CT values of patients in both groups, using receiver operating characteristic (ROC) curve to evaluate the diagnostic efficacy of single detection and combined detection.

RESULTS

SPECT/CT bone imaging in patients with bone metastasis from pulmonary cancer showed abnormal radioactive accumulation in spine, pelvis and bilateral ribs. Serum ALP, BAP and CT values in bone metastasis group were overtly higher than the non-bone metastasis group (P < 0.001). Logistic regression analysis showed that serum ALP, BAP and CT value were independent risk factors for bone metastasis from pulmonary cancer. The AUC value and Youden index of combined diagnosis were higher than those of single diagnosis.

CONCLUSION

SPECT/CT bone imaging combined with serum detection of ALP and BAP in patients with pulmonary cancer is helpful for early diagnosis of bone metastasis, which provides more basis for the formulation and selection of clinical treatment options.

Isolated distal ulnar bone metastasis from lung squamous cell carcinoma: an extremely rare case report

Bone metastases commonly occur in patients with lung cancer. However, metastasis from primary lung carcinoma to the bone below the knee and elbow is rarely encountered. We herein describe a man who developed an isolated distal ulnar bone metastasis originating from lung squamous cell carcinoma. A 68-year-old man presented to our orthopedic outpatient clinic for evaluation of a rapidly progressing tumor over his right wrist area. Tenderness with increased local temperature was noted, and the tumor was firm in consistency, oval-shaped, and 7 × 5 cm in size. Magnetic resonance imaging and radiographic imaging revealed an osteolytic tumor in his distal ulnar shaft. A 99m Tc-phosphate bone scan showed that this tumor was isolated and newly observed compared with the previous bone scan findings during initial diagnosis. Bone tumor biopsy confirmed metastatic squamous cell carcinoma. Segmental tumor resection with cementation was subsequently performed. This rare case report of an isolated ulnar metastasis includes detailed descriptions of the clinical, radiographic, and pathological features of the tumor.

Hyoid Bone Metastasis in Patients With Lung Adenocarcinoma: A Case Report

OBJECTIVE

Hyoid bone metastasis from lung adenocarcinoma is exceedingly rare. This study aims to provide an experience to clinicians in the differential diagnosis of hyoid tumors and discusses its possible source.

METHODS AND RESULTS

We report a 68-year-old male patient having hyoid bone metastasis from lung adenocarcinoma. The initial symptom of the hyoid bone metastasis was neck pain exacerbated by swallowing. The hyoid bone mass was resected based on comprehensive analysis including whole-body bone imaging and pathologic analysis of the hyoid bone mass. The adenocarcinoma of hyoid was identified as a metastatic lesion of lung adenocarcinoma. The patient recovered well and the anterior cervical pain was significantly alleviated after surgery and the patient underwent corresponding chemotherapy.

CONCLUSION

In patients with hyoid metastasis of lung adenocarcinoma, surgical resection may reduce the pain in anterior cervical after full consideration of physical condition.