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最初被当作退行性脊柱疾病治疗的原发性骨与软组织肿瘤的延迟诊断

Delayed Diagnosis of Primary Bone and Soft Tissue Tumors Initially Treated as Degenerative Spinal Disorders.

作者信息

Nishisho Toshihiko, Sakai Toshinori, Tezuka Fumitake, Higashino Kosaku, Takao Shoichiro, Takata Yoichiro, Miyagi Ryo, Toki Shunichi, Abe Mitsunobu, Yamashita Kazuta, Nagamachi Akihiro, Sairyo Koichi

机构信息

Department of Orthopedics, Institute of Biomedical Sciences Tokushima University Graduate School.

出版信息

J Med Invest. 2016;63(3-4):274-7. doi: 10.2152/jmi.63.274.

Abstract

Background Symptoms of primary bone and soft tissue tumors located in the trunk mimic those of degenerative spinal disorders such as low back pain or pain or numbness of the legs. Due to their rarity, especially in sarcoma located in the trunk, diagnosis is sometimes delayed. Methods A retrospective review was performed of the records of 383 patients with primary bone and soft tissue tumors who visit our out patient clinic from 2011 to 2013 at a single institution. Patients with delayed diagnosis of primary bone and soft tissue tumors initially treated as degenerative spinal disorders for more than 2 months were identified. Results Of the 383 patients, 5 (1.3%) were initially diagnosed as having degenerative spinal disorders. All 5 patients had bone or soft tissue tumors in the lumbar spine or pelvis. Three patients had a malignant tumor (osteosarcoma, chondrosarcoma, or small round cell sarcoma) at the progressive stage, and 1 died of lung metastasis. Two patients had a benign tumor (aneurysmal bone cyst or simple bone cyst). Conclusions Our findings suggest that when low back pain and leg pain are refractory to conservative treatment, further radiological examination should be conducted. J. Med. Invest. 63: 274-277, August, 2016.

摘要

背景 位于躯干的原发性骨与软组织肿瘤的症状与诸如腰痛或腿部疼痛或麻木等退行性脊柱疾病的症状相似。由于其罕见性,尤其是位于躯干的肉瘤,诊断有时会延迟。方法 对2011年至2013年在一家机构门诊就诊的383例原发性骨与软组织肿瘤患者的记录进行回顾性研究。确定了最初被当作退行性脊柱疾病治疗超过2个月的原发性骨与软组织肿瘤延迟诊断患者。结果 在383例患者中,5例(1.3%)最初被诊断为患有退行性脊柱疾病。所有5例患者在腰椎或骨盆有骨或软组织肿瘤。3例患者处于进展期时有恶性肿瘤(骨肉瘤、软骨肉瘤或小圆细胞肉瘤),1例死于肺转移。2例患者有良性肿瘤(动脉瘤样骨囊肿或单纯骨囊肿)。结论 我们的研究结果表明,当腰痛和腿痛对保守治疗无效时,应进行进一步的影像学检查。《医学调查杂志》63: 274 - 277,2016年8月。

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