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Haematogenous metastasis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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:

  • regions drained by the portal system - mets to the liver
  • regions drained by the caval system - mets to the lungs

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.

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