Alelaumi Ahmad, Alfawareh Mohammad, Althunibat Ismail, Al-Ibraheem Akram, Barakat Fareed
Department of Orthopedics and Spine Surgery, King Hussein Cancer Center, Amman, Jordan
Department of Orthopedics and Spine Surgery, King Hussein Cancer Center, Amman, Jordan.
Int J Spine Surg. 2023 Oct;17(5):661-669. doi: 10.14444/8523. Epub 2023 Jul 24.
Sarcoidosis is a chronic inflammatory condition characterized by the formation of granulomas, which can impact various organs and tissues throughout the body. It frequently affects the lungs and mediastinal lymph nodes. The presence of multiple lytic lesions in the spine can be concerning, as it may indicate an undiagnosed or advanced metastatic malignancy. We present an unusual and interesting case of sarcoidosis in which the patient had multiple lytic lesions in the vertebrae, which resembled the presentation of metastatic malignant disease.
A 46-year-old woman with no known medical history presented to our cancer center complaining of neck pain and bilateral shoulder pain. After conducting extensive investigations, an atypical manifestation of sarcoidosis was identified. The patient was administered corticosteroids, which effectively managed the disease and resulted in a substantial improvement in her symptoms.
Before considering surgical intervention or radiotherapy for cases involving multiple lytic lesions in the spine with an unknown primary cause, it is essential to conduct a comprehensive diagnostic evaluation. This thorough work-up is necessary to establish a clear diagnosis. If the patient's neurological condition permits, a complete assessment can help prevent substantial morbidity. In certain cases, a patient's condition may involve an atypical manifestation of pathologies that are not related to metastatic diseases, suggesting that simpler treatment approaches might be adequate.
结节病是一种慢性炎症性疾病，其特征为肉芽肿形成，可累及全身各个器官和组织。它常影响肺部和纵隔淋巴结。脊柱出现多个溶骨性病变可能令人担忧，因为这可能表明存在未确诊的或晚期转移性恶性肿瘤。我们报告一例不寻常且有趣的结节病病例，该患者椎体有多个溶骨性病变，类似于转移性恶性疾病的表现。
一名46岁无已知病史的女性到我们癌症中心就诊，主诉颈部疼痛和双侧肩部疼痛。经过广泛检查，确诊为结节病的非典型表现。给予患者皮质类固醇治疗，有效控制了病情，症状有显著改善。
在考虑对病因不明的脊柱多个溶骨性病变病例进行手术干预或放疗之前，必须进行全面的诊断评估。这种全面的检查对于明确诊断是必要的。如果患者神经状况允许，全面评估有助于预防严重的发病率。在某些情况下，患者病情可能涉及与转移性疾病无关的非典型病理表现，这表明采用更简单的治疗方法可能就足够了。
