Question:medium
A 49-year-old man suffering from carcinoma of prostate was X-rayed. He showed areas of sclerosis and collapse of T10 and T11 vertebra in X-ray. The spread of this cancer to the above vertebrae was through
A 49-year-old man suffering from carcinoma of prostate was X-rayed. He showed areas of sclerosis and collapse of T10 and T11 vertebra in X-ray. The spread of this cancer to the above vertebrae was through
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Prostate cancer reaches distant vertebrae via Batson's valveless internal vertebral venous plexus.
Updated On: Jul 8, 2026
- Sacral canal
- Lymphatic vessels
- Internal vertebral plexus of veins
- Superior rectal veins
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The Correct Option is C
Solution and Explanation
Step 1: Understanding the Concept:
Prostate cancer commonly causes sclerotic bone lesions in the spine even though the prostate sits nowhere near the thoracic vertebrae. The question wants the pathway that lets cancer cells jump that distance.
Step 2: Key Formula or Approach:
Cancer can spread by direct extension, lymphatics, or blood vessels. For prostate cancer reaching mid thoracic vertebrae, the important blood route is a special valveless venous network around the spine, called the internal vertebral (Batson's) venous plexus.
Step 3: Detailed Explanation:
The prostatic venous plexus connects with this vertebral plexus. Since the vertebral plexus has no valves, blood, and any tumour cells inside it, can flow in either direction depending on pressure changes in the chest and abdomen, for example during coughing. This allows prostate cancer cells to travel upward and lodge in the vertebral bodies, including T10 and T11, producing the sclerotic collapse seen on X-ray. The sacral canal is only a bony passage and carries no blood or cells. Lymphatic spread mainly reaches pelvic lymph nodes, not distant vertebrae in this pattern. Superior rectal veins belong to the portal drainage of the rectum and have no connection to prostate metastasis.
Step 4: Final Answer:
The correct route is the internal vertebral plexus of veins, option (3).
Prostate cancer commonly causes sclerotic bone lesions in the spine even though the prostate sits nowhere near the thoracic vertebrae. The question wants the pathway that lets cancer cells jump that distance.
Step 2: Key Formula or Approach:
Cancer can spread by direct extension, lymphatics, or blood vessels. For prostate cancer reaching mid thoracic vertebrae, the important blood route is a special valveless venous network around the spine, called the internal vertebral (Batson's) venous plexus.
Step 3: Detailed Explanation:
The prostatic venous plexus connects with this vertebral plexus. Since the vertebral plexus has no valves, blood, and any tumour cells inside it, can flow in either direction depending on pressure changes in the chest and abdomen, for example during coughing. This allows prostate cancer cells to travel upward and lodge in the vertebral bodies, including T10 and T11, producing the sclerotic collapse seen on X-ray. The sacral canal is only a bony passage and carries no blood or cells. Lymphatic spread mainly reaches pelvic lymph nodes, not distant vertebrae in this pattern. Superior rectal veins belong to the portal drainage of the rectum and have no connection to prostate metastasis.
Step 4: Final Answer:
The correct route is the internal vertebral plexus of veins, option (3).
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