ijn

Membership Revoked
Removed
Nov 8, 2009
1,333
18
Status
Medical Student
I am having a problem with this concept. So metastatic breast cancer to the bone can cause both blastic and lytic lesions. Let's say you have a female breast cancer patient with increased uptake in the bone on an imaging scan. What would their calcium, phosphate, and PTH levels be?

Also, what would the levels of those three substances be for a metastatic prostate cancer?

Thanks!
 
Apr 11, 2012
194
5
Status
Medical Student
I am having a problem with this concept. So metastatic breast cancer to the bone can cause both blastic and lytic lesions. Let's say you have a female breast cancer patient with increased uptake in the bone on an imaging scan. What would their calcium, phosphate, and PTH levels be?

Also, what would the levels of those three substances be for a metastatic prostate cancer?

Thanks!
Metastatic calcifications differ from dystrophic because metastatic ones are always due to increased Ca and/or phosphate.

Osteoblastic metastases (prostate cancer) deal with direct bone destruction, that causes high alkaline phosphatase -> reactive bone formation. So I guess, elevated Ca, elevated phosphate and decreased PTH.

Osteolytic mts - when tumor produces substances that activate osteolysis, i.e. IL-1, PTH-related peptide (squamous cell carcinoma in lungs, renal cell carcinoma).
If high PTHrp: elevated Ca, decreased phosphate


Breast cancer can do both


Edit:
I might be wrong,look what i found http://www.orthobullets.com/pathology/8045/metastatic-cancer-of-bone
 
Last edited:
OP
ijn

ijn

Membership Revoked
Removed
Nov 8, 2009
1,333
18
Status
Medical Student
For some reason I have it in my head that osteoblastic lesions cause hypocalcemia, hypophosphatemia, and high reactive PTH since you're increasing bone formation. Are you really just forming osteoid without mineralization? And those activated osteoblasts are concurrently activating osteoclasts thus resulting in hypercalcemia?
 
Apr 11, 2012
194
5
Status
Medical Student
For some reason I have it in my head that osteoblastic lesions cause hypocalcemia, hypophosphatemia, and high reactive PTH since you're increasing bone formation. Are you really just forming osteoid without mineralization? And those activated osteoblasts are concurrently activating osteoclasts thus resulting in hypercalcemia?
You're right, osteoblasts consume calcium and phosphate to form bone, this is the reason why lesions are radiodense. So increased consumption of these minerals would lead to hypocalcemia and hypophosphatemia.

And in osteolytic: it's hypercalcemia and hypophosphatemia (due to PTHrp that uses the same receptors as PTH ) and low PTH (because negative fb from Ca), that's why bones with mts are lucent.
 

Attachments

May 4, 2012
4
1
Status
Non-Student
Hey, i am sorry but i can't say anything about this because right now i am not having knowledge about it, if i will find something then i will surely tell you.
 
  • Like
Reactions: theTruth_97

VisionaryTics

Señor Member
10+ Year Member
Jan 14, 2009
1,925
2,315
Status
Fellow [Any Field]
Hey, i am sorry but i can't say anything about this because right now i am not having knowledge about it, if i will find something then i will surely tell you.
Thanks for checking in.

Post of the century.