Osteoblastic bone metastases secondary to adenocarcinoma of the pancreas

The incidence of bone metastases secondary to adenocarcinoma of the exocrine pancreas is unknown since radiological studies of the bones during life, routine bone scintigrams or extensive examination of the skeleton at autopsy is rarely undertaken in the absence of specific clinical indications. Symptom-producing bone metastases are relatively uncommon; a review of the literature suggests that the vast majority are osteolytic in nature with only a few isolated case reports of purely blastic deposits. In the authors' experience osteoblastic bone metastases are commoner than is generally recognised. Of 12 patients with symptom-producing bone deposits secondary to adenocarcinoma of the pancreas, five (41.6%) were purely blastic in nature. The clinical, radiological and pathological findings in these five cases are reported in order to emphasise that the pancreas is a potential source of purely blastic bone metastases and should be considered as a possible primary site in patients who present initially with osteoblastic bone deposits of unknown origin.