[Bone metastasis as a sign of the existence of latent neoplasia]

A series of 65 patients in whom bone metastasis was the earliest sign of tumour is examined. The diagnostic aspects of the bone metastasis from laboratory examination to radiology, from scintigraphy to bone marrow biopsy are analysed as is the problem of locating the primary tumours that remain of unknown site. The prognosis is poor for all such patients. The possibility of altering the course of the disease and the quality of the patient's life depends on the site and type of the primary neoplasm concerned. Effective systemic palliative treatment is currently only available for plasmacytomas and lymphomas in general, for cancers of the prostate, breast, thyroid and gonads and for a certain number of small cell lung cancers. In the light of the present study and data from the literature it is concluded that the approach to early bone metastasis patients should concentrate on the search for tumours responsive to treatment using simple clinical and instrumental examination techniques.