Assessment of suspected bone metastases

1997 ◽  
Vol 38 (5) ◽  
pp. 890-895 ◽  
Author(s):  
I. Çiray ◽  
G. Åström ◽  
C. Sundström ◽  
H. Hagberg ◽  
H. Ahlström
Keyword(s):  
Bone Metastases ◽  
Bone Biopsy ◽  
Clinical Information ◽  
Benign Lesions ◽  
True Negative ◽  
Ct Guided ◽  
Negative Results ◽  
Skeletal Lesion ◽  
Bone Biopsies ◽  
Malignant Lesions

Purpose: To evaluate the role of CT with and without clinical information as compared to CT-guided bone biopsy in the assessment of suspected bone metastases. Material and Methods: The study comprised 51 consecutive patients with suspected bone metastases who had undergone CT-guided bone biopsies with an eccentric drill system. CT of the targets, clinical information, and histopathology were scored separately as malignant, uncertain or benign. The results of CT alone and CT in combination with clinical information were compared to the results of histopathology. Results: Histopathology diagnosed 45/51 lesions (88%), 23 as malignant and 22 as benign. CT correctly depicted 17 of these 23 malignant lesions. The remaining 6 malignant lesions were CT-scored as uncertain (n=5) or benign (n=l). CT correctly depicted only 3 of the 22 benign lesions. The remaining 19 benign lesions were CT-scored as malignant (n=2) or uncertain (n=17). When uncertain CT scores were combined with clinical scores, the true-positive and true-negative results for malignancy increased from 44% to 82%. Conclusion: In most cases, CT in combination with clinical information gives enough information about the nature — malignant or benign — of a skeletal lesion. In uncertain cases, diagnostic accuracy can be improved by means of CT-guided bone biopsy.

Combined Ct-Guided Biopsy and Cytology in Diagnosis of Bony Lesions

1992 ◽  
Vol 33 (3) ◽  
pp. 225-229 ◽  
Author(s):  
T. Tikkakoski ◽  
S. Lähde ◽  
J. Puranen ◽  
M. Apaja-Sarkkinen
Keyword(s):  
Fine Needle Aspiration ◽  
Bone Biopsy ◽  
False Negative ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Fine Needle ◽  
Negative Results ◽  
Bone Biopsies ◽  
Ct Guided Biopsy ◽  
Bony Lesions

The results of 44 trephine (OD 1.4–4 mm) biopsies and 39 fine needle (0.7–0.9 mm) aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in 54 patients were evaluated. The fine needle sample was aspirated through the trephine as a complementary procedure in 29 patients and a fine needle aspiration only was performed in 10 patients. Trephine biopsy only was performed in 15 patients. Sufficient material for histologic and cytologic analyses was obtained in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined examinations the fine needle aspiration alone was diagnostic in 2 cases while the trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both the cytologic and histologic samples were adequate for diagnostic purposes. In one case both methods gave false-negative results. The combined use of cytologic and histologic samples in CT-guided bone biopsies increased diagnostic accuracy. The aorta was perforated once with a 1.4-mm needle but without sequelae. CT-guided bone biopsy was found to be a safe, reliable and cost-efficient method.

scholarly journals Differences in Radiation Exposure of CT-Guided Percutaneous Manual and Powered Drill Bone Biopsy

2021 ◽  
Author(s):  
Sebastian Zensen ◽  
Sumitha Selvaretnam ◽  
Marcel Opitz ◽  
Denise Bos ◽  
Johannes Haubold ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Diagnostic Yield ◽  
Bone Biopsy ◽  
Lumbar Vertebrae ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Thoracic Vertebrae ◽  
Level Of Evidence ◽  
Ct Guided ◽  
Bone Biopsies

Abstract Purpose Apart from the commonly applied manual needle biopsy, CT-guided percutaneous biopsies of bone lesions can be performed with battery-powered drill biopsy systems. Due to assumably different radiation doses and procedural durations, the aim of this study is to examine radiation exposure and establish local diagnostic reference levels (DRLs) of CT-guided bone biopsies of different anatomical regions. Methods In this retrospective study, dose data of 187 patients who underwent CT-guided bone biopsy with a manual or powered drill biopsy system performed at one of three different multi-slice CT were analyzed. Between January 2012 and November 2019, a total of 27 femur (A), 74 ilium (B), 27 sacrum (C), 28 thoracic vertebrae (D) and 31 lumbar vertebrae (E) biopsies were included. Radiation exposure was reported for volume-weighted CT dose index (CTDIvol) and dose–length product (DLP). Results CTDIvol and DLP of manual versus powered drill biopsy were (median, IQR): A: 56.9(41.4–128.5)/66.7(37.6–76.2)mGy, 410(203–683)/303(128–403)mGy·cm, B: 83.5(62.1–128.5)/59.4(46.2–79.8)mGy, 489(322–472)/400(329–695)mGy·cm, C: 97.5(71.6–149.2)/63.1(49.1–83.7)mGy, 627(496–740)/404(316–515)mGy·cm, D: 67.0(40.3–86.6)/39.7(29.9–89.0)mGy, 392(267–596)/207(166–402)mGy·cm and E: 100.1(66.5–162.6)/62.5(48.0–90.0)mGy, 521(385–619)/315(240–452)mGy·cm. Radiation exposure with powered drill was significantly lower for ilium and sacrum, while procedural duration was not increased for any anatomical location. Local DRLs could be depicted as follows (CTDIvol/DLP): A: 91 mGy/522 mGy·cm, B: 90 mGy/530 mGy·cm, C: 116 mGy/740 mGy·cm, D: 87 mGy/578 mGy·cm and E: 115 mGy/546 mGy·cm. The diagnostic yield was 82.4% for manual and 89.4% for powered drill biopsies. Conclusion Use of powered drill bone biopsy systems for CT-guided percutaneous bone biopsies can significantly reduce the radiation burden compared to manual biopsy for specific anatomical locations such as ilium and sacrum and does not increase radiation dose or procedural duration for any of the investigated locations. Level of Evidence Level 3.

A pilot study on the clinical value of 18F-sodium fluoride PET/CT in advanced prostate cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10589-10589
Author(s):  
Joseph W. Kim ◽  
Maria Liza Lindenberg ◽  
William L. Dahut ◽  
James L. Gulley ◽  
Ravi A. Madan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Sodium Fluoride ◽  
Advanced Prostate Cancer ◽  
Bone Scan ◽  
Malignant Lesion ◽  
Benign Lesions ◽  
Pet Ct ◽  
Medicine Physician ◽  
Malignant Lesions

10589 Background: We evaluated the clinical utility of 18F-sodium fluoride PET/CT bone scan (18F-NaF) in the detection of bone metastases in patients (pts) with prostate cancer in comparison with Technetium-99m MDP bone scan (TcBS). Methods: In a prospective study, from October 2010-December 2011, 30 prostate cancer pts (ages 51-79), 21 with known bone metastases and 9 without known bone metastases, had18F-NaF and a TcBS performed. Abnormal foci of uptake on both TcBS and 18F-NaFwere classified as benign, malignant or indeterminate. Benign lesions included uptake in the joints and linear uptake at the endplates of the vertebral bodies consistent with degenerative changes. Malignant uptake on 18F-NaF scans was confirmed by characteristic osteoblastic features on CT. All TcBS and 18F-NaF were reviewed by an experienced nuclear medicine physician. For the patient-based analysis, scan results were categorized as positive (POS) = any malignant lesion; indeterminate (IND) = not distinctly malignant or benign; negative (NEG) = benign lesions only. Results: In the lesion-based analysis, 21 of 30 (70%) pts had more malignant lesions identified on 18F-NaF than on TcBS. The mean number of additional malignant lesions per patient on 18F-NaF vs TcBS was 4. Eight of the 30 pts had same number of malignant lesions identified in both studies. One of 30 pts had one less malignant lesion identified on 18F-NaF than on TcBS. CT correlation by 18F-NaF PET/CT of this particular lesion did not confirm osteoblastic feature. Malignant lesion distribution on 18F-NaF included: spine (28%), thorax (26%), pelvis (24%), long bones (13%) and skull (10%). In the patient-based analysis, 24 pts (80%) were POS by 18F-NaF, of whom 14 pts were POS, 8 were IND, and 2 were NEG by corresponding TcBS; in the 4 pts with NEG 18F-NaF, zero were POS, 2 were IND and 2 were NEG by corresponding TcBS. Conclusions: 18F-NaF identified more malignant lesions than TcBS. 18F-NaF may also add useful information in the management of advanced prostate cancer pts with and without known bone metastases.

scholarly journals Detection of PIK3CA Mutations in Breast Cancer Bone Metastases

ISRN Oncology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8
Author(s):  
Manijeh Daneshmand ◽  
Jennifer E. L. Hanson ◽  
Mitra Nabavi ◽  
John F. Hilton ◽  
Lisa Vandermeer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Bone Metastases ◽  
Cancer Cells ◽  
Primary Tumour ◽  
Breast Cancer Patients ◽  
Ct Guided ◽  
Mutation Status ◽  
Bone Biopsies ◽  
Metastatic Sites

Background. An important goal of personalized cancer therapy is to tailor specific therapies to the mutational profile of individual patients. However, whole genome sequencing studies have shown that the mutational profiles of cancers evolve over time and often differ between primary and metastatic sites. Activating point mutations in the PIK3CA gene are common in primary breast cancer tumors, but their presence in breast cancer bone metastases has not been assessed previously. Results. Fourteen patients with breast cancer bone metastases were biopsied by three methods: CT-guided bone biopsies; bone marrow trephine biopsies; and bone marrow aspiration. Samples that were positive for cancer cells were obtained from six patients. Three of these patients had detectable PIK3CA mutations in bone marrow cancer cells. Primary tumor samples were available for four of the six patients assessed for PIK3CA status in their bone metastases. For each of these, the PIK3CA mutation status was the same in the primary and metastatic sites. Conclusions. PIK3CA mutations occur frequently in breast cancer bone metastases. The PIK3CA mutation status in bone metastases samples appears to reflect the PIK3CA mutation status in the primary tumour. Breast cancer patients with bone metastases may be candidates for treatment with selective PIK3CA inhibitors.

scholarly journals Role of FNAC in diagnosis of parotid lesions

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Youssef ◽  
Daren Cope ◽  
Sundus Alsedra ◽  
Mohamed Zahran ◽  
Abdel Rahman El Tahan
Keyword(s):  
Salivary Gland ◽  
False Negative ◽  
Benign Lesions ◽  
True Negative ◽  
Histopathological Correlation ◽  
John Hunter ◽  
Malignant Group ◽  
Malignant Lesions ◽  
Sensitivity Specificity

Abstract Background Salivary gland masses are considered challenging for diagnosis regarding its origin and whether benign or malignant. Unique features of FNAC as a safe and easy diagnostic procedure with little discomfort to the patient made it a favorable primary diagnostic tool. Information regarding the nature of parotid lesions whether being benign or malignant is the main objective of FNAC. We have done a restrospective study for FNAC for parotid masses performed in John Hunter hospital (Newcastle, NSW, Australia) along the peroid from 2014-2018. Histopathological correlation was done in 74 cases to test the accuracy of FNAC in diagnosis of parotid lesions. Results Of the total 74 FNAC done for parotid lesions in which a histopathological correlation was done, we get 46 (62.2%) benign lesions (37 neoplastic and 9 non-neoplastic) while 28 (37.8%) were malignant tumor. Pleomorphic adenoma was the most common in benign tumor side (45.7%) while SCC is the most common in malignant group (53.6%). Compatibility between FNAC and histological diagnosis was found in 74% (55/74), of which 78.3% in benign lesions (36/46) and in 68% of malignant lesions (19/28). FNA cytology was true positive in 21/74 cases (28.4%) and true negative in 41/74 (55.4%) cases. We have 5 (6.8%) false-negative and 7 (9.5%) false-positive results. As a result, we get sensitivity of 81%, specificity of 85%, and accuracy of 84%. Conclusion The role of FNAC in diagnosis of primary salivary gland pathology is considered with some debate about sensitivity/specificity; however, sometimes it should be repeated or correlated with clinical/histopathological confirmation.

The Diagnostic Performance of Wide-Angle Digital Breast Tomosynthesis in Comparison to Hand-Held 2D Ultrasound in the Evaluation of Probably Benign & Malignant Lesions in Dense Breast Parenchyma

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 33-33
Author(s):  
I. Ewais ◽  
A. Awis ◽  
Y. Fahim ◽  
S. Khodair ◽  
H. Gewefel
Keyword(s):  
Diagnostic Performance ◽  
Digital Breast Tomosynthesis ◽  
Dense Breast ◽  
Architectural Distortion ◽  
Wide Angle ◽  
Benign Lesions ◽  
Breast Tomosynthesis ◽  
Dense Breasts ◽  
Negative Results ◽  
Malignant Lesions

Background: Imaging of dense breast represents a diagnostic challenge for interpreting radiologists. Tomosynthesis and ultrasound are used as additional imaging tools to compensate the lower sensitivity of 2D mammography when examining a dense breast. This study compares the diagnostic performance of 50° wide-angle digital breast tomosynthesis (wide-angle DBT) to hand-held breast ultrasound (HHUS) in the evaluation of probably benign and malignant breast lesions in dense breast. Patients and Methods: A retrospective review of 131 women with dense breasts (ACR C and D) was conducted during a 12-months period (October 2018 -October 2019). Out of the 131 women; 40 cases (30.5%) were reported to have 64 probably benign and malignant lesions (BI-RADS 3, 4 and 5) detected by combined wide-angle DBT and HHUS. Patients with negative results (BI-RADS 1) or typically benign lesions (BI-RADS 2) were excluded from this study. Median age for the included 40 cases=46.8 years (range =30-67). Women above the age of 40 (n=35, 87%) were examined with combined 2D mammogram + wide-angle DBT and ultrasound. Women below 40 (n=5, 13%) were initially examined by ultrasound and obtained complementary wide-angle DBT mammography based on clinical necessity. Separate BI-RADS were given for each modality and independently correlated with histopathological results for BI-RADS 4 and 5, or routine follow up images for BI-RADS 3. Results: Among the 64 lesions; 10 (15.6%) were pathologically proven malignant in 5 cases (two cases were presenting with multi-focal disease), and 54 (84.4%) benign lesions pathologically proven or followed up in 35 patients. Sensitivity was 100% for wide-angle DBT (10/10) and 80% for ultrasound (8/10). Specificity and positive predictive value for ultrasound was 94.4% (51/54) and 72.7% (8/11), respectively. For wide-angle DBT, specificity was 90.7% (49/54) and positive predictive value was 66.7% (10/15). Despite the high sensitivity, in our study, DBT showed equal diagnostic accuracy to that of breast ultrasound (92.2%, 59/64). Both modalities were not similar in depicting malignant lesions; two more lesions were initially identified at wide-angle DBT images presented as <1cm area of architectural distortion (p=0.07). Other two diagnostic cases presented with acute inflammatory symptoms; they showed architectural distortion in DBT, which were false-positives for the later, yet, ultrasound showed mastitis and abscess formation. Ultrasound significantly identified more benign lesions than DBT mammography (p=0.001). Conclusion: Wide-angle DBT and HHUS are indispensable in identifying probably benign and malignant lesions in dense breasts. Our study showed the role of Wide-angle DBT in detecting small (<1 cm) malignant lesions presenting as architectural distortion. However, the radiologists experience with DBT and the significant clinical information added by ultrasound may impact the diagnostic performance. Therefore, supplemental HHUS to wide-angle DBT will increase accuracy and true negative results for a lower benign biopsy rate.

Ct-guided bone biopsy in cancer patients with suspected bone metastases: retrospective review of 308 procedures

2014 ◽  
Vol 119 (11) ◽  
pp. 852-860 ◽  
Author(s):  
Lorenzo Monfardini ◽  
Lorenzo Preda ◽  
Gaetano Aurilio ◽  
Stefania Rizzo ◽  
Vincenzo Bagnardi ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Cancer Patients ◽  
Retrospective Review ◽  
Bone Biopsy ◽  
Ct Guided

scholarly journals Atypical presentation of colorectal carcinoma with sole multiple osteolytic bone metastases: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ren Kawamura ◽  
Yudai Suzuki ◽  
Yukinori Harada ◽  
Taro Shimizu
Keyword(s):  
Colorectal Cancer ◽  
Bone Metastases ◽  
Diagnostic Delay ◽  
Vertebral Osteomyelitis ◽  
Gastrointestinal Symptoms ◽  
Sudden Onset ◽  
Bone Lesions ◽  
Ct Guided ◽  
Osteolytic Lesions ◽  
Bone Biopsies

Abstract Background The incidence of colorectal cancer in persons aged < 50 years has been increasing. The diagnosis of colorectal cancer is not difficult if the patient has typical symptoms; however, diagnosis may be difficult in cases with atypical symptoms and signs. We present here an atypical case of metastatic colorectal cancer with fever and sudden onset paraplegia as the sole manifestations. The patient had multiple osteolytic lesions without gastrointestinal symptoms or signs, which resulted in a diagnostic delay of colorectal cancer. Case presentation A 46-year-old Japanese man was transferred to our hospital for evaluation of fever. He had developed fever 8 weeks previously and had been first admitted to another hospital 5 weeks ago. The patient was initially placed on antibiotics based on the suspicion of a bacterial infection. During the hospital stay, the patient experienced a sudden onset of paralysis and numbness in his both legs. Magnetic resonance imaging showed an epidural mass at the level of Th11, and the patient underwent a laminectomy. Epidural abscess and vertebral osteomyelitis were suspected, and antimicrobial treatment was continued. However, his fever persisted, and he was transferred to our hospital. Chest, abdominal, and pelvic computed tomography (CT) with contrast showed diffusely distributed osteolytic lesions. Fluorodeoxyglucose-positron-emission tomography showed high fluorodeoxyglucose accumulation in multiple discrete bone structures; however, no significant accumulation was observed in the solid organs or lymph nodes. A CT-guided bone biopsy obtained from the left iliac bone confirmed the evidence of metastatic adenocarcinoma based on immunohistochemistry. A subsequent colonoscopy showed a Borrmann type II tumor in the sigmoid colon, which was confirmed to be a poorly differentiated adenocarcinoma. As a result of shared decision-making, the patient chose palliative care. Conclusions Although rare, osteolytic bone metastases as the sole manifestation can occur in patients with colorectal cancer. In patients with conditions difficult to diagnose, physicians should prioritize the necessary tests based on differential diagnoses by analytical clinical reasoning, taking into consideration the patient’s clinical manifestation and the disease epidemiology. Bone biopsies are usually needed in patients only with sole osteolytic bone lesions; however, other rapid and useful non-invasive diagnostic tests can be also useful for narrowing the differential diagnosis.

scholarly journals Increased uptake of 68Ga-DOTA-FAPI-04 in bones and joints: metastases and beyond

2021 ◽  
Author(s):  
Chunxia Qin ◽  
Yangmeihui Song ◽  
Xi Liu ◽  
Yongkang Gai ◽  
Qingyao Liu ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Bone Diseases ◽  
Bone Lesions ◽  
Benign Lesions ◽  
Osteofibrous Dysplasia ◽  
Benign Diseases ◽  
Pet Ct ◽  
Malignant Lesions ◽  
The Mean

Abstract Purpose: To describe the uptake of 68Gallium-labelled fibroblast activation protein inhibitor (68Ga-FAPI) in bones and joints for better understanding of the role of 68Ga-FAPI PET in benign and malignant bone lesions and joint diseases. Methods: All 129 68Ga-FAPI PET/MR or PET/CT scans from June 1, 2020 to February 20, 2021 performed at our PET centre were retrospectively reviewed. Foci of elevated 68Ga-FAPI uptake in bones and joints were identified. All lesions were divided into malignant and benign disease. Benign lesions included osteofibrous dysplasia, periodontitis, degenerative bone diseases, arthritis, and other inflammatory or trauma-related abnormalities. The number, locations and SUVmax of all lesions were recorded and analysed. Results: Elevated uptake of 68Ga-FAPI in/around bones and joints were found in 82 cases (63.57%). A total of 295 lesions were identified, including 94 (31.9%) malignant lesions (all were metastases) and 201 (68.1%) benign lesions. The benign lesions consisted of 13 osteofibrous dysplasia, 48 degenerative bone disease, 33 periodontitis, 56 arthritis, and 51 other inflammatory or trauma-related abnormalities. Spine, shoulder joint, alveolar ridge, and pelvis were the most commonly involved locations. Bone metastases were mainly distributed in the spine, pelvis and ribs. Among benign diseases, periodontitis and arthritis are site-specific. The mean SUVmax of bone metastases was significantly higher than that of benign diseases (7.14 ± 4.33 vs. 3.57 ± 1.60, p < 0.0001), but overlap existed. The differences in SUVmax among subgroups of benign diseases were statistically significant (p < 0.0001), with much higher uptake in periodontitis (4.45 ± 1.17). Conclusion: 68Ga-FAPI accumulated in both bone metastases and some benign diseases of bones and joints. Although the uptake of 68Ga-FAPI was often higher in bone metastases, this finding cannot be used to distinguish between benign and malignant lesions.

scholarly journals AB0793 CONTRIBUTION OF INVESTIGATIONS FOR THE QUEST OF PRIMITIVE CANCER IN FRONT OF BONE METASTASIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1421.3-1422
Author(s):  
S. Boussaid ◽  
S. Rekik ◽  
S. Mechergui ◽  
S. Jemmali ◽  
E. Cheour ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Tumor Markers ◽  
Bone Biopsy ◽  
Specific Antigen ◽  
Bone Cancer ◽  
Diagnostic Methods ◽  
Primary Cancer ◽  
Bone Biopsies

Background:Bone metastases (OM) or secondary cancers bones are bony locations of tumor cells, away from a primary malignant tumor. The Bone metastases are the most common metastases. They can be revealing in 20 to 30% cases or complicate the course of a known cancer. The bone metastases are a pejorative prognostic factor.Objectives:The aim of this study was to identify the Contribution of diagnostic methods for the quest of primitive cancer in presence of bone metastasis.Methods:We conduct a retrospective study of 35 files of patients who were hospitalized in the rheumatology department. All patients underwent a questionnaire and a clinical examination. Additional radiological assessment, bone biopsies, biopsies of other sites, bone scintigraphy and tumor markers were carried out on a case-by-case basis.Results:Thirty-five cases (25 men and 10 women) were analysed. The average age was 61 years [45-85]. Seven patients had a known history of neoplasia. One or more bone biopsies were performed in 8 cases. The vertebrae were the most biopsied bone site (6 cases). The bone biopsies were in favour of carcinoma (3 cases), adenocarcinoma (2 cases), squamous cell carcinoma (1 case) and inconclusive (2 cases). Non bony biopsies (2 pulmonary, 2 prostatic, 1 mammary) concluded to an adenocarcinoma (3 cases) and a carcinoma (2 cases). Bone scintigraphy was carried out in 7 cases and showed in all cases diffuse or localized hyperfixation. The localized value of tumor markers appeared relatively low except for Prostate Specific Antigen (PSA). Other metastatic localisations were identified: hepatic (6 cases) and pulmonary (1 case). The primary cancer identified was pulmonary for 11 patients, prostatic for 7, gynaecological for 4 and digestive for 3. One patient had Otorhinolaryngological cancer and another had bone cancer. Bone biopsy allowed the diagnosis in 6 cases (17%). The primary cancer was discovered by a biopsy of other non-bone sites in 5 cases (14%). Neoplastic antecedents and clinical context were considered sufficient in 16 cases (45%). Primary cancer remained undetermined in 8 cases (22%).Conclusion:Bone biopsy, as well as non-bone biopsy, remains an essential tool in the etiological diagnosis of bone metastases. They are very contributive in the same proportions. PSA is a major diagnostic asset in the search for primary cancer.Disclosure of Interests:None declared

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