Patient: The patient is female, 62 years old. She started to have pain in her back six months ago, and the pain worsened after New Year’s. Ten days ago, she started to feel numbness in her lower limbs, and now she can walk with something in her hand. The doctor initially diagnosed it as bone tumor (bone cancer). The diagnosis has not been confirmed yet, and she is not receiving regular treatment and is preparing for a bone scan. I would like to ask for confirmation of the diagnosis and give advice on the next step of treatment or examination. 1.Some doctors suggest to exclude myeloma and lymphoma on blood and to perform whole body bone scan, do you think it is necessary? 2.What tests can we use now to determine the nature of the bone tumor? 3.Is this surgery very risky and is there any possibility of healing? Tang Shun, Department of Bone Oncology, Peking University People’s Hospital: After reading your imaging data, it is a vertebral body tumor combined with pathological fracture and compression of spinal cord. Firstly, the nature of the tumor should be clarified, and secondly, surgery should be performed as soon as possible to stabilize the spine, release the compression and relieve the symptoms. The patient should be bedridden before surgery to avoid acute paraplegia. A whole-body bone scan is necessary to determine whether the tumor is multifocal or solitary. Both myeloma and lymphoma are malignant bone tumors of bone marrow origin, usually presenting as multiple bone destruction. Performing a hematologic examination is of differential significance. However, in elderly patients, it is more common to find bone metastatic cancer. The most direct and effective method is to perform puncture for pathology of the patient’s tumor lesions for a definitive diagnosis, which requires the physician to have sufficient experience. Surgery has clear implications for symptom relief, prevention of acute paraplegia, clarification of pathological diagnosis, and improvement of quality of life. I do not think that patients have too much risk to worry about. In addition, it should be pointed out that even if it is bone metastasis cancer, it does not mean that the patient loses the right to live a healthy life, the treatment of tumor has been greatly improved, a large number of patients can survive with tumor for a long time, and some bone metastasis cancer can be cured. Please have confidence and don’t be anxious. The nature of the tumor can be clarified first before further treatment can be effective.