Kong Adrian C, Zarate Stephanie D, Belzarena Ana C
Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL, 33199.
Orthopedic Oncology Department, Miami Cancer Institute 8900 N Kendall Dr, Miami, FL, 33176.
Radiol Case Rep. 2021 Nov 1;17(1):72-76. doi: 10.1016/j.radcr.2021.10.002. eCollection 2022 Jan.
Pathologic fractures are common complications of metastatic bone disease in patients with breast cancer. Fractures involving the proximal femur generally cause significant pain that is exacerbated by ambulation. Due to excessive stress on the weight-bearing hip joint, these fractures present a significant burden on the quality of life among patients. Here we describe a case of a 38-year-old female patient who was found to have a pathologic fracture of the proximal femur missed on imaging studies that underwent spontaneous union. Pathologic fractures rarely heal on their own, since a tumor at the fracture site interferes with bone healing and most fractures have to be managed with surgical intervention. Fractures can be missed on imaging studies in the setting of extensive metastatic disease. Physicians should be cognizant of this fact and maintain a high level of suspicion to recognize fractures with unusual presentations where patients may not present with the typical findings of acute onset of pain and inability to ambulate or bear weight.
病理性骨折是乳腺癌患者转移性骨病的常见并发症。累及股骨近端的骨折通常会导致严重疼痛，行走时疼痛加剧。由于负重髋关节承受过大压力，这些骨折给患者的生活质量带来了重大负担。在此，我们描述一例38岁女性患者，其股骨近端病理性骨折在影像学检查中被漏诊，但随后自行愈合。病理性骨折很少能自行愈合，因为骨折部位的肿瘤会干扰骨愈合，大多数骨折必须通过手术干预来处理。在广泛转移性疾病的情况下，影像学检查可能会漏诊骨折。医生应认识到这一事实，并保持高度警惕，以识别具有不寻常表现的骨折，因为这类患者可能不会表现出急性疼痛发作以及无法行走或负重的典型症状。
