What Are the Causes of Lytic Bone Lesions?
Destruction of an area of bone that is caused by either a malignant or benign disease is called a lytic lesion of the bone, according to the National Cancer Institute. These types of lesions can be seen on radiology studies such as an X-ray; however, the type of condition that is causing the lesion cannot be fully determined by the X-ray alone. Other information that can help determine the cause of the lytic bone lesion includes the specific age group of the patient, the location of the lesion within the bone and the size of the lytic lesion. Once the physician determines the cause of the lytic lesion, the physician can begin the appropriate therapy.
Primary Bone Cancer
Several types of primary bone cancers can cause lytic lesions of the bone. According to The Norwich Image Interpretation Course, osteosarcoma is the most common primary malignant bone cancer. Ewing’s sarcoma, another type of bone cancer, occurs in the long bones such as the arms and legs. Chondrosarcoma is another malignant tumor that occurs in older adults.
As noted on the International Myeloma Foundation website, multiple myeloma is a cancer of the bone marrow. In many patients with myeloma, bone destruction is very common and is responsible for some of the symptoms of this disease, such as severe bone pain. In most patients with multiple myeloma, the patient has multiple lytic bone lesions.
Metastases to Bone
Many different types of cancer can metastasize to the bone, such as renal cancer, breast cancer and prostate cancer, according to The Norwich Image Interpretation Course. These lytic lesions are often painful and can fracture. The treatment for metastases depends on the type of cancer that has spread, according to the Cecil Textbook of Medicine.
Solitary Bone Cyst
A benign cause of a lytic bone lesion is a solitary bone cyst, as noted on The Norwich Image Interpretation Course. This occurs in people under 30 and typically appears in the long arm bone or the humerus. This condition is usually without symptoms unless there is a fracture to the area.
Giant Cell Tumour
A giant cell tumor is an aggressive benign bone tumor; this tumor is more common in people between 20 and 40 years of age, according to the American Academy of Orthopaedic Surgeons. These tumors are not associated with trauma or diet. The lytic lesion can fracture in this condition as well.
Another benign condition that causes lytic lesions of the bone is fibrous dysplasia. In this condition, the normal bone is replaced by scar tissue; this causes the bone to weaken, as noted on the Mayo Clinic website. In most patients, only one bone is involved.
A chronic bone infection is called osteomyelitis, which can present as a lytic lesion on radiologic studies as well. The bone can become infected after an injury or from an infection traveling in the blood. According to the Mayo Clinic, this condition is typically treated with surgery to remove some of the infected bones and long-term antibiotic therapy.