Lundeberg Kathleen Renee, Vidis Laura J, Martin Jennifer, Randolph-Habecker Julie
Student Physician, Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, USA
Student Physician, Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, USA.
BMJ Case Rep. 2021 Nov 19;14(11):e241333. doi: 10.1136/bcr-2020-241333.
Soft tissue sarcomas (STSs) are rare and may often be misdiagnosed, resulting in delays in treatment. A 67-year-old cisgender woman with type 2 diabetes mellitus and obesity presented to her primary care physician with a mass on her left proximal arm. The clinical opinion of the attending physician was that of an insulin injection site reaction. After further evaluation from the physician, the patient was diagnosed with a lipoma without confirmatory histology. The patient continued to present with an enlarging mass, decline in health status and continued with local wound care. The patient underwent a confirmatory biopsy following which, the patient was diagnosed with leiomyosarcoma. This case report highlights the case of a person with a low or moderate income with a self-reported low health literacy living in a rural community and how STS may be misdiagnosed in medically underserved. The patient's primary or oncology care team are not involved in the production or review of this case report.
软组织肉瘤(STSs)较为罕见,常常可能被误诊,从而导致治疗延误。一名67岁的顺性别女性,患有2型糖尿病和肥胖症,因左上肢近端出现肿物而就诊于她的初级保健医生。主治医生的临床诊断意见为胰岛素注射部位反应。经医生进一步评估后,患者被诊断为脂肪瘤,但未进行组织学确诊。患者肿物持续增大,健康状况下降,继续接受局部伤口护理。患者接受了确诊性活检,之后被诊断为平滑肌肉瘤。本病例报告强调了一名生活在农村社区、自称健康素养较低且收入不高或中等的患者的情况,以及在医疗服务不足地区软组织肉瘤如何可能被误诊。本病例报告的撰写或审核未涉及患者的初级保健团队或肿瘤护理团队。