The skeleton is one of the commonest sites for metastasis. Bone secondaries account for more than one third of the ‎malignant disease of bone.‎
Seventy-six patients with bone secondaries were admitted in the orthopaedic department of Basrah Teaching ‎Hospital from February 2000 to June 2002, age range 14-86 years; 34 were males and 42 were females. The ‎dominant sites of bone metastases were spine, 60 patients (79%) and pelvis, 16 patients (21%). The common ‎primary sites were breast, 19 patients (25%) and lung, 11 patients (14.4%); 9 patients (11.2%) had undetected ‎primary site. Most secondaries (90%) were osteolytic in type and the most common histopathological type was ‎adenocarcinoma, 47 patients (63%). In 63 patients (83%), pain was the dominant presenting feature. Late ‎presentation was a major problem; it ranges between 4-8 months. Another problem was lack of clinical awareness ‎in the early stage of the illness.‎
Serum and urinary biochemical markers of bone metabolism were significantly high in patients with bone ‎secondaries than control group, no difference whether the metastasis was single or multiple and whichever the ‎primary site or histopathological subtype. Special interest with urinary hydroxyproline, it was significantly elevated ‎in patients with bone secondaries, some of them had negative radiography. Prognosis was poor with short life ‎expectancy.‎