Füsun AYDOĞAN, Ebuzer KALENDER, Murat RIFAİOĞLU, Recep DOKUYUCU

Kemik metastazlarının iskelet sistemindeki bölgesel dağılımı

Giriş: Kemik metastazları iskelet sisteminin en sık görü- len malign lezyonlarıdır. Çalışmamızın amacı sintigrafik olarak tespit edilen kemik metastazlarının iskelet sistemindeki bölgesel dağılımını belirlemektir. Yöntemler: Çalışmaya Ocak 2012 ve Ağustos 2013 tarihleri arasında kliniğimizde kemik sintigrafisi çekimi yapı- lan primer maligniteli 97 hasta (53 erkek, 44 kadın) dahil edildi. Hastaların yaş ortalaması 59,0±15,9 (yaş aralığı, 19-84) yıl idi. Kemik metastazı olan hastalar ve bu metastazların bölgesel dağılımı tespit edildi. Bulgular: Hastaların 38inde (%39,2) kemik metastazı tespit edildi. Otuz iki (%84,2) hastada metastazlar multipl, 6 (%15,8) hastada ise soliter (tek) idi. Kemiğe metastaz yapan malignitelerin 15i (%39,5) prostat kanseri, 8i (%21) meme kanseri, 2si (%5,3) akciğer kanseri, 3ü (%7,9) mesane kanseri, 10u (%26,3) ise diğer malignitelerden (rektum, mide, serviks, lenfoma vs) oluşmaktaydı. Doksan iki adet metastaz bölgesi saptandı. Bunların 24ü (%26,1) vertebra, 15i (%16,3) pelvik kemikler, 17si (% 18,5) kosta, 6sı (% 6,5) üst ekstremite, 12si (% 13) alt ekstremite, 5i (% 5,45) kalvaryum, 6sı (% 6,5) sternum, 4ü (% 4.35) skapula, 3ü (% 3,3) klavikula idi. Sonuç: Kemik metastazları metastatik kanser olgularının 2/3ünde saptanmaktır. Kemik metastazlarının en sık izlendiği bölge aksiyel iskelet sistemidir ve bu sistem içerisinde de vertebralar ilk sırayı almaktadır. Kemik metastazlarının değerlendirilmesinde kullanılan en önemli görüntüleme yöntemi ise kemik sintigrafisidir.

Regional distribution of bone metastases in skeletal system

Objective: Bone metastases are the most common malign lesions of skeletal system. The aim of this study is to determine regional distribution of bone metastases detected scintigraphically. Methods: Ninety-seven patients (53 male, 44 female) with primary malignancy who performed bone scintigraphy in our clinic between January 2012 and August 2013 included to study. The mean age of patients was 59±15.9 years (range 19-84).The patients who had bone metastasis and regional distribution of these metastases were detected. Results: Bone metastasis was detected in 38 (39.2%) of all patients. The metastases were multipl in 32 (84.2%) patients and single in 6 (15.8%) patients. Fifteen of malignancies that metastasize to bone were prostate cancer in 15 (39.5%) patients, breast cancer in 8 (21%) patients, lung cancer in 2 (5.3%) patients, urinary bladder cancer in 3 (7.9%) patients and other malignancies (rectum, stomach, cervix, lymphoma etc.) in 10 (26.3%) patients. Ninety-two metastasis regions were detected. 24 (26.1%) of them were vertebrae, 15 (16.3%) of them were pelvic bone, 17 (18.5%) of them were costa, 6 (6.5%) of them were upper extremity, 12 (13%) of them were lower extremity, 6 (6.5%) of them were calvarium, 6 (6.5%) of them were sternum, 4 (4.35%) of them were scapula and 3 (3.3%) of them were clavicula. Conclusion: Bone metastases are detected in two thirds of metastatic cancer cases. The most common site of bone metastases is axial skeletal system and vertebrae take the first place in this system. Bone scintigraphy is the most important imaging modality used in the evaluation of bone metastases.

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