A 50-year-old man suffering from carcinoma of prostate showed areas of sclerosis and collapse of T10 and Til vertebrae in X-ray. The spread of this cancer to the above vertebrae was most probably through:
Ans. is 'c' i.e. internal vertebral plexus of veins Prostatic cancer spreads to the bones through blood vessels; first into the periprostatic venous plexus and then into the internal vertebral plexus of veins. This metastatic is possible because of valveless communication* between the periprostatic and vertebral plexus of veins. Points of importance - Most common sites* of bony metastatic for prostatic CA-: Pelvis > Lumbar vertebra > thoracic vertebra > head of the femur > the ribs > the humerus (Note that both Bailey and S.Das agree that pelvis* is the most common site for bony metastasis) Bony metastasis of prostate CA are mainly osteoblastic* and cause sclerotic lesions.
Sacral canal
Lymphatic vessels
Internal vertebral plexus of veins
Superior rectal veins