Diagnostic oncology case study: lytic spine lesion and cold bone scan.

In summary, when photon-deficient lesions are demonstrated on bone scans of patients in the cancer age group, metastatic disease should be the first consideration. This is especially true in the presence of a lytic bone lesion. Bronchogenic and breast carcinomas are the most common primaries. A negative physical examination and normal CEA levels do not exclude the possibility of metastatic breast cancer.