Skip to main content
SpringerLink
Log in

Morphological Findings in Bone Metastasis, Tumorosteopathy and Antiosteolytic Therapy

  • Conference paper
Metastatic Bone Disease

Abstract

Bone metastases are an important complication of malignant disease as the skeleton is the third most common site of metastases after the filter organs lung and liver. Bone metastases are in fact metastases of the bone marrow, and the term bone metastasis — although it has been used since the beginning of clinical interest in this subject — is therefore incorrect. The tumor cells growing in the bone marrow can disturb skeletal and calcium homeostasis and cause structural and compositional alterations of the bone tissue termed tumor osteopathy or osteopathy of malignancy. Due to the associated bone pain, pathological fractures, and hypercalcemia, metastases to bone can considerably influence the course and prognosis of a neoplastic disease. As metastases to bone are the expression of hematogenous dissemination the detection of osseous metastases means that curative therapy of malignancy is no longer possible. Osseous metastases are therefore generally considered a sign of prognostic deterioration of the malignant disease, although cases with osseous metastases alone are associated with longer survival times than those with extraosseous metastases (Wander 1986). Bone metastases are not responsible for cancer mortality but rather but cancer morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Adami S, Mian M (1989) Clodronate therapy of metastatic bone disease in patients with prostatic carcinoma. Recent Results Cancer Res 116: 67–72

    PubMed  CAS  Google Scholar 

  • Albelda SM (1993) Biology of disease: role of integrins and other cell adhesion molecules in tumor progression and metastasis. Lab Invest 68 (1): 4–114

    PubMed  CAS  Google Scholar 

  • Axhausen G (1909) Histologische Studien über die Ursachen und den Ablauf des Knochenumbaus in osteolystischen Karzinomen. Virchows Arch Pathol Anat 195: 358–462

    Article  Google Scholar 

  • Boonekamp PM, Van der Weel-Pals LJA, Van Wijk-Van Lennep MML, Thesing, CW, Bijovoet OLM (1988) Two modes of action of bisphosphonates on osteoclastic resorption of mineralized matrix. Bone Miner 1: 27–39

    Google Scholar 

  • Bucher EM (1993) Immunzytologische Diagnostik und Bedeutung von Tumorzellen im Knochenmark bei Patienten mit kleinzelligem Bronchialkarzinom. Thesis, University of Heidelberg

    Google Scholar 

  • Cheng SY, Geldof AA, Newling Don WW, Rao R (1992) Progression delay of prostate tumor skeletal metastasis effects by bisphosphonates. J Urol 148: 1270–1273

    Google Scholar 

  • Clarke NW, McClure J, George NJR (1991a) Morphometric evidence for bone destruction and replacement in prostate cancer. Br J Urol 68: 74–80

    Article  PubMed  CAS  Google Scholar 

  • Clarke NW, McClure J, George NJR (1991b) Clinical and metabolic effects of dis- odium Pamidronate in metastatic prostate cancer. In: Osteoclast inhibition in the management of malignancy-related bone disorders. OLM Bijvoet, A Lipton (eds) Hogrefe and Huber, Göttingen

    Google Scholar 

  • Coleman RE, Rubens RD (1985) Bone metastasis and breast cancer. Cane Treat Rev 12: 251

    Article  CAS  Google Scholar 

  • Coombes RC, Dady P, Parsons C, McCready VR, Ford HT, Gazet J-C, Powles TJ (1983) Assessment of response of bone metastases to systemic treatment in patients with breast cancer. Cancer 52: 610–614

    Article  PubMed  CAS  Google Scholar 

  • Dearnaley DP, Sloane JP, Omerod MG et al. (1981) Increased detection of mammary carcinoma cells in marrow smears using antisera to epithelial membrane antigen. Br J Cancer 44: 85

    Article  PubMed  CAS  Google Scholar 

  • Delmas PD, Charhon S, Chapuy MC, Vignon E, Brianeon D, Edouard C, Meunier PJ (1982) Long-term effects of dichloromethylene diphosphonate (CL2MDP) on skeletal lesion in multiple myeloma. Metab Bone Dis Res 4: 163–168

    Article  CAS  Google Scholar 

  • Diel IJ, Kaufmann M, Goerner R, Costa SD, Kaul S, Bastert G (1992) Detection of tumor cells in bone marrow of patients with primary breast cancer: a prognostic factor of distant metastasis. J Clin Oncol 10: 1534–1539

    PubMed  CAS  Google Scholar 

  • Elomaa J, Blomquist C, Porkka L, Holmström T, Laine H (1984) Long-term effects of dichlormethylene diphosphonate in patients with osteolytic bone metastases and coincident primary hyperparathyroidism. Cancer Treat Rep 68 (4): 655–657

    PubMed  CAS  Google Scholar 

  • Elomaa J, Blomquist C, Porkka L, Holmström T, Taube T, Lamberg-Allardt C, Borgstrom GH (1988) Clodronate for osteolytic metastases due to breast cancer. Biomed Pharmacother 42 (2): 111–116

    PubMed  CAS  Google Scholar 

  • Ewerbeck V, Friedl W (1992) Chirurgische Therapie von Skelettmetastasen. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Fidler IJ (1987) Review: biological heterogeneity of cancer metastases. Breast Cancer Res Treat 9: 17–26

    Article  PubMed  CAS  Google Scholar 

  • Flanagan AM, Chambers TJ (1987) Dichloromethylene bisphosphonate (C12MBP) inhibits bone resorption through injury to osteoclasts that resorb CL2MBP- coated bone. Bone Miner 6: 33–43

    Article  Google Scholar 

  • Fleisch H (1988) Bisphosphonates: a new class of drugs in disease of bone and calcium metabolism. In: Brunner KW, Fleisch H, Senn JH (eds) Bisphosphonates and tumor osteolysis. Recent results in cancer research. Springer, Berlin Heidelberg New York, pp 1–28

    Google Scholar 

  • Galasko CSB (1976) Mechanism of bone destruction in development of skeletal metastases. Nature 263: 507

    Article  PubMed  CAS  Google Scholar 

  • Gullino PM, Liotta LA (1981) Cell shedding by tumors. In: Weiss L, Gilbert HA (eds) Bone metastasis. Hall, Boston, pp 11–47

    Google Scholar 

  • Huflfer WE (1988) Morphology and biochemistry of bone remodeling: Possible con¬trol by vitamin D, parathyroid hormone, and other substances. Lab Invest 59 (4): 418–442

    Google Scholar 

  • Krempien B, Manegold C (1992) Zur Indikation einer frühen Bisphosphonat-Therapie bei Patienten mit soliden Tumoren. Dtsch Ärztebl 89: 1234–1238

    Google Scholar 

  • Krempien B, Manegold C (1993) Prophylactic treatment of skeletal metastases, tumor-induced osteolysis and hypercalcemia in rats with the bisphosphonate C12MBP. Cancer 72 (1): 91–98

    Article  PubMed  CAS  Google Scholar 

  • Krempien B, Lemminger FM, Ritz E, Weber E (1978) The reaction of different skeletal sites to metabolic bone disease - a micromorphometric study. Klin Wochenschr 56: 755

    Article  PubMed  CAS  Google Scholar 

  • Krempien B, Wingen F, Eichmann T, Müller M, Schmähl D (1988) Protective effects of a prophylactic treatment with the bisphosphonate 3-amino-l-hydroxypropane- 1,1-bisphosphonic acid on the development of tumor osteopathies in the rat: experimental studies with the Walker carcinosarcoma 256. Oncology 45: 41–46

    Article  PubMed  CAS  Google Scholar 

  • Krempien B, Guo J, Büchele R (1989) Regulation of the cellular compartment of bone and bone marrow by factors of the microenvironment. J Bone Miner Res 4 [Suppl 1]: S168

    Google Scholar 

  • Kuhlenkampff HA, Delling G (1984) Stimulation der osteoclastären Osteolyse bei Knochenmetastasen - eine quantitative Untersuchung. Verh Dtsch Ges Path 68: 518

    Google Scholar 

  • Magro C, Orr WF, Manishen WJ, Sivananthan K, Mokashi SS (1985) Adhesion, Chemotaxis, and aggregation of Walker carcinosarcoma cells in response to products of resorbing bone. J Natl Cancer Inst 74 (4): 829–838

    PubMed  CAS  Google Scholar 

  • Manegold C, Krempien B, Schwechheimer K, Kaufmann M (1986) Cytokeratin anti-bodies in the early detection of bone marrow involvement in breast cancer. J Cancer Res Clin Oncol 111: 71

    Article  Google Scholar 

  • Manegold C, Krempien B, Mall G, Drings P (1989 a) Möglichkeiten und Grenzen der Beckenkammstanzbiopsie in der Diagnostik von Knochenmetastasen. Pathologe 10: 118–124

    Google Scholar 

  • Manegold C, Krempien B, Bülzebruck H, Drings P (1989b) Value of bilateral iMac crest needle biopsy for pretherapeutic tumor staging of bronchogenic carcinomas. Oncology 46: 226–229

    Article  PubMed  CAS  Google Scholar 

  • Mansi JL, Berger U, Easton D, McDonnell T, Redding WH, Gazet JC, McKinna A, PowlesTJ, Coombes RC (1987) Micrometastases in bone marrow in patients with primary breast cancer: evaluation as an early predictor of bone metastases. Br Med J 295: 1092–1097

    Article  Google Scholar 

  • Mansi JL, Berger U, Wilson P (1988) Detection of tumor cells in bone marrow of patients with prostatic carcinoma by immunocytochemical techniques. J Urol 139: 545

    PubMed  CAS  Google Scholar 

  • Meinshausen J, Choritz H, Georgii A (1980) Frequency of skeletal metastases as revealed by routinely taken bone marrow biopsies. Virchows Arch A Pathol Anat Histopathol 399: 409–417

    Google Scholar 

  • Mundy GR (1991) Mechanisms of osteolytic bone destruction. Bone 12 [Suppl 1]: S 1

    Article  Google Scholar 

  • Mundy GR, DeMartino S, Rowe DW (1981) Collagen and collagen-derived fragments are chemotactic for tumor cells. J Clin Invest 68: 1102–1105

    Google Scholar 

  • Mundy GR, Varani J, Orr W et al. (1980) Resorbing bone is chemotactic for monocytes. Nature 275: 132

    Article  Google Scholar 

  • Mundy GR (1987) Bone resorption and turnover in health and disease. Bone 8 (1): 9–16

    Google Scholar 

  • Nemoto R, Uchida K, Tsutsumi M, Koiso K, Satou S, Satou T (1987) A model of localized osteolysis induced by the MBT-2 tumor in mice and its responsiveness to etidronate disodium. J Cancer Res Clin Oncol 113: 539–543

    Article  PubMed  CAS  Google Scholar 

  • Nyström JS, Weiner JM, Heffeldinger-Juttner J (1977) Metastatic and histologic pres¬entation in unknown primary cancer. Semin Oncol 4: 53

    Google Scholar 

  • Paget S (1889) The distribution of secondary growth in cancer of the breast. Lancet I: 571–573

    Google Scholar 

  • Paterson AHG, Powles TJ, Kanis JA, McClashey E, Hanson J, Ashley S (1993) Double-blind controlled trial of oral clodronate in patients with bone metastases from breast cancer. J Clin Oncol II (1): 59–65

    Google Scholar 

  • Pollard M, Lückert PH (1985) Effects of dichloromethylene disphosphonate on the osteolytic and osteoplastic effects of rat prostate adenocarcinoma cells. Natl Cancer Inst 75: 649–654

    Google Scholar 

  • Orr W, Varani J, Gondec MD et al. (1979) Chemotactic responses of tumor cells to products of resorbing bone. Science 203: 176

    Article  PubMed  CAS  Google Scholar 

  • Orr FW, Kostenuik P, Sanchez-Sweatman OH, Singh G (1993) Mechanisms involved in the metastasis of cancer to bone. Breast Cancer Res Treat 25: 151–163

    Article  PubMed  CAS  Google Scholar 

  • Ralston SH, Fogelman I, Gardner MO et al. (1984) Hypercalcemia of malignancy: evidence for a non-parathyroid humoral agent with an effect on renal tubular handling of calcium. Clin Sei 66: 187

    CAS  Google Scholar 

  • Recklinghausen von FD (1891) Die fibröse und deformierende Ostitis, die Osteomalazie und die osteoplastische Carcinose in ihren gegenseitigen Bedingungen. Festschrift für Rudolf Virchow. Reimer, Berlin

    Google Scholar 

  • Sargent NSE, Oestreicher H, Haidvogl H, Madnick HM, Burger MM (1988) Growth regulation of cancer metastases by their host organ. Proc Natl Aad Sci USA 85: 7252–7255

    Google Scholar 

  • Schlimok G, Funke I, Bock B, Schweiberer B, Witte J, Riethmüller G (1990) Epithelial tumor cells in bone marrow of patients with colorectal cancer: immuncyto- chemical detection, phenotypic characterization, and prognostic significance. J Clin Oncol 8 (5): 8831–8837

    Google Scholar 

  • Stahel RA, Mabry M, Skarin J, Bernal SD (1985) Detection of bone marrow metastases in small cell lung cancer by monoclonal antibody. J Clin Oncol 3: 455

    PubMed  CAS  Google Scholar 

  • Sigwart A, Theurer S (1991) Untersuchungen zum Wachstum von Tumorzellen in bestrahltem Knochen und Knochenmark am Modell des Walkercarcinosarkomes 256 der Ratte. Thesis, University of Heidelberg

    Google Scholar 

  • Theriault RL, Hortobagyi GN (1992) Bone metastasis in breast cancer. Anticancer Drugs 3 (5): 455–462

    Article  PubMed  CAS  Google Scholar 

  • Uehlinger E (1981) Sekundäre Knochengeschwülste. In: Schinz HR, Baensch WE, Frommhold W, Glauner R, Uehlinger E, Wellauer J (eds) Lehrbuch der Röntgendiagnostik. Thieme, Stuttgart, pp 702–752

    Google Scholar 

  • Vlodansky I, Fuks Z, Schirrmacher V (1983) Studies on tumor cell interaction with the vascular endothelium and the subendothelial basal lamina: relationship to tumor metastasis. In: Thilo-Körner DSG, Freshney RI (eds) The endothelial cell - a pluripotent control cell of the vessel wall. Karger, pp 126–157

    Google Scholar 

  • Vorreuther R, Klotz T, Engelking R (1992) Clodronat in der palliativen Therapie des ossär metastasierenden Prostatakarzioms. Urologe, Ausgabe A 31: 63–66

    CAS  Google Scholar 

  • Wander HE (1986) Prognosefaktoren beim metastasierenden Mammakarzinom, In: Nagel GA (ed) Mammkarzinome. Neue Perspektiven experimenteller und klinischer Therapieforschung. Springer, Berlin Heidelberg New York, pp 1–12

    Google Scholar 

  • Zettler BR (1990) The cellular basis of site-specific tumor metastasis. N Engl J Med 332 (9): 605–612

    Google Scholar 

Download references

Authors
  1. B. Krempien
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Universitäts-Frauenklinik, Voss-Straß 9, 69115, Heidelberg, Germany

    Ingo J. Diel , M. Kaufmann  & G. Bastert ,  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Krempien, B. (1994). Morphological Findings in Bone Metastasis, Tumorosteopathy and Antiosteolytic Therapy. In: Diel, I.J., Kaufmann, M., Bastert, G. (eds) Metastatic Bone Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78596-2_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78596-2_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-57356-2

  • Online ISBN: 978-3-642-78596-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation