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Metastatic patterns of solid tumors outside the CNS

Non-central nervous system solid tumors spread primarily to lymph nodes, lungs, the liver, and bone marrow. Metastasis to the central nervous system is rare.

  • Neuroblastoma can frequently metastasize to the bone.
  • Malignant liver tumors metastasize primarily to the lungs and lymph nodes, but can also spread to bone. Liver tumors only rarely metastasize to bone marrow.
  • Rhabdomyosarcoma can spread to the lungs, bone marrow, bone, and lymph nodes. 
  • For NRSTS, metastases often occur in the lungs. 
  • In 10-20% of children with osteosarcoma, metastases are present. Eighty percent of children with primary metastases only have metastases to the lungs. In the rest, metastases are localized both in bone and lungs. Skip metastases, metastases that occur in the same bone as the primary tumor, may be seen. Regional lymph node metastases are rare and infiltration in other localizations is also rare. 
  • Ewing's sarcoma and pPNET are found primarily in the pelvis, long bones of the lower extremities, and in the chest wall. They spread primarily to the lungs, bone, bone marrow, and rarely to lymph nodes and the central nervous system.

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