Lytic bone lesion is a general term used when the bone becomes extremely weak by a disease. Normal bone tissue constantly gets remodeling and repaired from time to time. Lytic lesion of bone is an area where the bone appears to have been eaten away. There are several diseases that can cause destruction of bone area. It can be caused due to malignancy or benign condition.
The three characteristic symptoms of any osteoltyic bone lesions are moderate to severe bone pain, pathologic fracture and high level of calcium in blood. It can also increase the risk of spinal cord fractures.On x-ray the weakened area appears as tiny holes and they are called as osteolytic lesions. People also refer these holes as moth eaten spots.
Treatment of osteolytic lesions usually involves medications that control further loss of bone tissue and radiation therapy to alleviate pain and other accompanying symptoms.
What Are The Causes Of Lytic Bone Lesions?
Osteolytic lesions occur when there are structural changes in the process of bone formation and degradation. Normally the bone gets remodeling from time to time. The old cells of bone skeleton are destroyed and they are replaced by the new growth of bone cells.However, sometimes the equilibrium of old and new cells is disturbed. For example as in case of particular type of cancer called myeloma, the process goes hay wire or gets disturbed. The production of new cells does not match with loss of old cells.
In myeloma there is mismatch of osteoblasts and osteoclast. Osteoblasts are bone cells that are involved in building bony structure and osteoclasts are bone cells that release certain substance which helps to breakdown bone while remodeling process is going on. In myeloma, the cancer stops osteoblasts but at the same time stimulates osteoclasts that do the work of breaking down the bone tissue. This leads to formation of hole or moth eaten pattern in the bone structure due to destruction of more bone cells than its formation.
Aside from myeloma, there are several other conditions especially malignancies that may cause osteolysis. For example metastatic tumor from breast cancer, prostate, lung and thyroid cancer all can cause osteolytic lesion of bone. In majority of cases the lesions are found on skull, spine, long bone of leg, ribs, and pelvic bone. Infection of bone can also lead to destruction and lysis of bone.
Prominent Symptoms Of Lytic Bone Lesions
Irrespective of the underlying cause which may be malignancy or benign in origin, lytic lesions of bone can produce range of symptoms. Here are some of the prominent symptoms of osteolytic process:
- Bone pain is very severe and is often associated with damage to the nerve. Nerve damage occurs because weak bone has tendency to be compressed. Nerve passing near or through it may get damaged.
- Osteoporosis of bone which leads to weakening of bone.
- Pathological fracture occurs as a result of weakened bone structure.
- High level of calcium in blood. This in medical terminology is called hypercalcemia. The broken bones release calcium into the blood. This may cause rise of calcium level in blood. Patient may suffer from symptom of hypercalcemia such as nausea, vomiting, confusion, myalgia, joint pain, etc.
Treatment Of Lytic Bone Lesions
Lytic lesions of bone need to be treated. It is necessary to prevent further deterioration of bone, alleviate pain and prevent fractures.
In majority of cases medications are given to reduce the incidence of osteoporosis. Modern medicines are now available especially in case of cancer causing lytic lesions of bone. They are as a preventive measure for worsening of the symptoms. These medications are given intravenously by the doctor. Low dose radiation is also used in some cases.