Pathogenesis of bone metastasis: a review


Prof. E. J. Raubenheimer, Department of Oral Pathology, Box D24, Medunsa Oral Health Center, University of Limpopo, PO Medunsa 0204, South Africa. Tel: 27-12-521-4838. Fax: 27-12-521-4839.


Background:  Metastasic deposits from malignancies frequently lodge in the skeleton, including the jawbones.

Method:  A review of the literature was performed in order to provide a coherent overview on the pathogenesis of bone metastasis.

Results:  Bone metastasis follows complex molecular interactions that enable tumor cells to detach from the primary site, invade the extracellular matrix, intravasate, extravasate, and proliferate within bone. They induce local bone changes that could manifest radiologically as either osteolytic or radiodense. In addition to the direct bone changes, malignancies can elaborate mediators that are released in circulation, leading to generalized osteopenia.

Conclusions:  The spread of malignant neoplasms to bone is not a random process but rather a cascade of specific molecular events orchestrated through complex interactions between neoplastic cells and their environment.