Metastatic bone disease – epidemiology, characteristics, and diagnostic possibilities

Metastatic bone disease (MBD) is a common problem among patients with malignant tumors. Bone tissue is the third most frequent site of metastasis, following the lungs and liver. The risk of bone metastases increases with the duration of the cancer disease. Early diagnosis should be implemented when a patient with malignant tumors reports symptoms such as bone pain, joint mobility disorders, or neurological symptoms. Attention should also be drawn to abnormalities in laboratory tests – elevated calcium levels in serum (hypercalcemia). In the case of fractures in atypical locations or occurring after low-energy trauma, oncological disease should be included in the differential diagnosis. The first-line imaging studies include X-rays and computed tomography. Magnetic resonance imaging is recommended in cases of diagnostic uncertainty or changes in the axial skeleton. Additionally, scintigraphy allows for determining the nature of the lesion and oncological staging (assessment of the number of metastatic lesions to the bones). Hybrid studies are also used, characterized by the best sensitivity and specificity parameters. If dealing with a tumor of unknown origin, the most important diagnostic step is biopsy, which should be performed by an experienced clinician at a bone cancer treatment center. The authors of the publication hope that the review presented below will help expand knowledge about MBD, optimize its diagnostic process, and improve medical care in Poland for patients with metastatic bone disease.