Metastatic disease of bone is the most common example of "bone cancer." The incidence of skeletal metastases varies from 6% to 85% depending on the primary tumor and the method of evaluation. Axial skeletal involvement is more common than appendicular involvement, and metastatic lesions below the elbow and knee are relatively uncommon. Fifty-seven autopsy subjects had had clinical evidence of metastatic involvement below the knee and elbow with an incidence of 7% (57/827). The lung was the most common primary site, and the tibia was the most common bone affected. Pain, local soft-tissue extension, and pathologic fractures were the most common presenting symptoms. Prior to 1960, most patients did not receive treatment. Until recent intervention, no treatment was offered to enhance the quantity or quality of patient survival.