Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Sternal metastases represent a rare but significant site of cancer spread.
• A multidisciplinary approach is essential for accurate diagnosis and effective management.
• Recent advancements in imaging and treatment necessitate an updated overview of the field.

Purpose of the Study:

• To provide a comprehensive overview of the latest data on sternal metastases.
• To analyze diagnostic strategies, patient outcomes, and histological findings.
• To consolidate findings from original research and case reports published between January 2020 and July 2023.

Main Methods:

• A narrative review of PubMed-indexed original articles.
• Search terms included "sternal", "manubrium", and "metastasis".
• Inclusion criteria focused on secondary sternal cancer spread in adults, encompassing 14 studies and 34 case reports.

Main Results:

• Analysis of incidence across various primary cancers (prostate, head and neck, glioblastoma).
• Comparative assessment of diagnostic imaging modalities like PET/CT and bone scintigraphy.
• Case report data indicated a female predominance (1.6:1 ratio) with common primary sites including breast and thyroid cancer.

Conclusions:

• Sternal metastases require a high index of suspicion and a multidisciplinary approach for diagnosis and management.
• Advanced imaging techniques like PET/CT offer superior diagnostic accuracy.
• Further research is needed to optimize therapeutic strategies and improve patient outcomes for this complex oncological challenge.