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Sarcomas most commonly spread by the haematogenous route but it is also used by carcinomas. Veins are far more frequently penetrated than arteries and thus the site of ultimate metastasis tends to follow the distribution of venous drainage from the site of origin:
Certain cancers lying close to the vertebral column may metastasize to bone via the intervening paravertebral plexus. Examples include thyroid and prostate carcinomas.
Renal cell carcinoma can invade the renal vein in a solid cord of cells, infrequently passing in continuity up to the inferior vena cava.