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 Bone Tumours
  These are either: 
 
  
    primary or secondary 
  
    benign or malignant 
   
  Secondary bone tumours are much more common than primary bone tumours
 
  Secondary bone tumours
  The tumours which most commonly metastasise to bone (i.e. the primary tumours) are: 
 
  
    BREAST
  
    BRONCHUS
  
    THYROID
  
    RENAL 
  
    PROSTATE
  
    BOWEL
   
  
    Location:
  
  Metastases are found in the axial skeleton – spine, pelvis, ribs, long bones
 
  
    Presentation: 
    in all cases the primary tumour may or may not be known
 
  
    Bone pain – night pain common +/- constitutional symptoms (weight loss, fatigue)
  
    Pathological fracture – tumour cells weaken bone by activating osteoclasts
  
    Spinal cord compression – pressure of tumour on nerve roots causing leg weakness
  
    Incidental – raised alkaline phosphatase on routine blood tests or osteolytic lesion on x-ray taken for another reason  
   
  
    Investigations:
  
 
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