In adults, destructive bone lesions are more commonly caused by which disease rather than primary bone malignancy?

• A. Metastatic disease
• B. Osteomyelitis
• C. Osteosarcoma
• D. Ewing sarcoma

Answer: (A)

Destructive bone lesions in adults are most often due to metastatic disease rather than a primary bone cancer. The skeleton is a common site for hematogenous spread from cancers such as breast, prostate, lung, kidney, and thyroid. These metastases can produce lytic, blastic, or mixed lesions and frequently involve the spine, pelvis, and proximal long bones. Primary malignant bone tumors like osteosarcoma or Ewing sarcoma are far more common in younger patients; in adults they’re relatively rare. Osteomyelitis can destroy bone as well, but it’s an infectious process, not a malignancy, and metastases remain the more frequent cause of destructive bone lesions in the adult population.