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hours he was virtually asymptomatic and able to eat solid food, including toast, without pain. In the six months since discharge he has remained completely well.A subsequent comprehensive investigation of his immunological system failed to show any abnormality. This included serum immunoglobulins (subclasses), T

Cancer involving bone is a common presentation to the orthopaedic team, and requires a structured team approach with careful preoperative and perioperative care. Metastatic or secondary cancer is the most common malignant disease involving bone, but haematological cancers involving the bone marrow can also present challenges to the surgical team. This article describes the investigation, decision and treatment options for metastatic bone disease. Primary bone cancer is rare and requires a specialist team approach to maximize survival and minimize complications. The management of primary bone cancer is summarized here.