title: Primary malignant tumours of bone following previous malignancy.
abstract: Destructive bone lesions occurring in patients who have previously had a malignancy are generally assumed to be a metastasis from that malignancy. We reviewed 60 patients with a previous history of malignancy, who presented with a solitary bone lesion that was subsequently found to be a new and different primary sarcoma of bone. These second malignancies occurred in three distinct groups of patients: (1) patients with original tumours well known to be associated with second malignancies (5%); (2) patients whose second malignancies were likely to be due to the previous treatment of their primary malignancy (40%); (3) patients in whom there was no clearly defined association between malignancies (55%). The purpose of this study is to emphasise the necessity for caution in assuming the diagnosis of a metastasis when a solitary bone lesion is identified following a prior malignancy. Inappropriate biopsy and treatment of primary bone sarcomas compromises limb salvage surgery and can affect patient mortality.
authors.affiliation: The Royal Orthopaedic Hospital Oncology Service, Royal Orthopaedioc Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
authors.forename: J T
authors.initials: JT
authors.lastname: Patton
authors.forename: S M M
authors.initials: SM
authors.lastname: Sommerville
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer