الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
After the lungs and liver, the skeleton is the most common site of metastatic
disease. Prostate, breast, lung, kidney, and thyroid cancers account for 80%
of all skeletal metastases, and the femur is the most common long bone
affected.Metastatic bone disease has a massive impact both on the well-being of patients, the survival of patients, and the cost of their care. In addition, the morbidity that is associated with bone metastasis can be devastating.There are two mechanisms involved in bone metastasis. The first mechanism is the intrinsic properties of the tumor cells, which potentiate the tumor cell’s ability to leave the site of primary neoplasia and take residence in a distant skeletal environment. The second mechanism , is the anatomic predisposition of the host that allows seeding of neoplastic cells in the specific regions of the skeletal system, and the properties of the skeletal host and its response to the migration of malignant cells from the site of primary tumor. Many factors are involed in the process of bone metastasis, In patients with
osteolytic bone metastasis some factors plays an important role in the bone
destructive process such as RANKL, Interleukin-3, Interleukin-6, PTHrP
and TGF-β, Platelet-Derived Growth Factor, Insulin-Like Growth Factors
and Other factors plays an important role in osteoplastic bone metastasis
such as Endothelin-1.