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Pathology ` PATHOLOGY—neOPLASIA Pathology ` PATHOLOGY—neOPLASIA SECtIoN II 223

Common metastases Most sarcomas spread hematogenously; most carcinomas spread via lymphatics. However, Four
Carcinomas Route Hematogenously: Follicular thyroid carcinoma, Choriocarcinoma, Renal cell
carcinoma, and Hepatocellular carcinoma.
SITe Of MeTASTASIS 1º TuMOr nOTeS
Brain Lung > breast > melanoma, colon, kidney 50% of brain tumors are from metastases A B
Commonly seen as multiple well-circumscribed
tumors at gray/white matter junction
Liver Colon >> Stomach > Pancreas (Cancer Liver C D and lung are the most common sites
Sometimes Penetrates liver) of metastasis after the regional lymph nodes
Bone Prostate, Breast > Kidney, Thyroid, Lung Bone metastasis E F >> 1° bone tumors (eg,
(Painful Bones Kill The Lungs) multiple myeloma)
Predilection for axial skeleton G
Bone metastasis can be:
ƒ Lytic (eg, thyroid, kidney, non-small cell
lung cancer)
ƒ Blastic (eg, prostate, small cell lung cancer)
ƒ Mixed (eg, breast cancer)
A B C G

D E F

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