Composition of Bone in Extreme Osteoporosis Associated with Hepatoma

Abstract

The presence of a marked degree of decalcification of the entire skeleton in a 10-year-old boy suffering from extensive carcino-matous involvement of the liver prompted the investigation herein reported. A preliminary report of the clinical and laboratory studies in this case was given last year by Hansen, Ziegler and McQuarrie. 1 The osteoporosis developed early in the course of the disease and continued to progress throughout the 18 months he was under observation. The specimen of rib bone obtained shortly after exitus was freed from all muscular attachments, cleaned, weighed and stored at −20°C until ready for analysis. The entire specimen was prepared for analysis in each case. The manner of preparation of the specimens, the chemical methods, and system of calculations were the modification of Kramer and Howland's 2 procedure, and are reported elsewhere. 3 The results of the analyses, calculated on green, dry, and dry extracted bases are presented in Table I, together with similar data obtained on the rib bones of a 9-year-old boy having no demonstrable abnormality of the osseous system.

The data in Table I show that there had been a marked replacement of bone minerals by lipid and water, amounting to 27.8% when regarding the bones of the control subject as normal. Slightly more than 80% of this was lipid (alcoholether soluble) material. The data also show that the dry, lipid-free bone of the hepatoma patient had 31.4% less Ca, 33.8% less P, 39.0% less Mg and 37.9% less CO₂ than that of the control. On the basis of the system of calculation employed, it appears from these results that there was relatively more CaCO₃ and Mg₃ (PO₄)₂ than Ca₃ (PO₄)₂ withdrawn from the bone.