ABSTRACT
A pathological fracture occurs through an area of abnormal bone. There is either a reduction in the quantity or quality of bone present. Bone metastases from visceral primary lesions or primary haematopoietic tumours such as myeloma are common and may lead to pathological fracture. There is a complex interaction between the host bone and the invading tumour cells, which influences the behaviour of the lesion. Patients presenting with a bone lesion may be known to have skeletal metastatic disease; it may be the first presentation of a malignancy or a presentation of progression of a previously diagnosed tumour. In patients who present with a lesion with no prior diagnosis of malignancy, a primary bone tumour must be excluded. Investigations are required to stage the lesion locally and distally and to identify the nature of the lesion. This information should then be discussed at a multidisciplinary clinical pathological conference to guide further management.
