Nasopharyngeal carcinoma: pattern of skeletal metastases

The records of 153 nasopharyngeal carcinoma patients with skeletal metastases were reviewed. The skeletal system was the most common site of distant metastases. The patients who developed skeletal metastases were significantly younger than those without skeletal metastases, although there was no difference between sexes. The pattern of skeletal involvement conforms to the general pattern, the spine and pelvis being the common sites. The first region of involvement was lumbar spine (28.4%), then dorsal spine (27.7%), sacrum and pelvis (16.3%), femur (9.9%), rib and sternum (7.8%), humerus (5.0%), cervical spine (3.5%) and skull vault (1.4%). Radiologically, the lesions were lytic in 66.0%, mixed lytic and sclerotic in 12.8% and sclerotic in 21.2%. The time to development of symptomatic skeletal metastases of mixed or sclerotic nature was significantly longer than lytic lesions, and patients with mixed or sclerotic metastases also had better survival.