Tumor Mimicking in Musculoskeletal System in Surabaya: A Case Series
Abstract
ABSTRACT
Musculoskeletal tumors are potential causes of heavy morbidity and economic burdens for patients. There are often cases suspected as musculoskeletal tumors based on a specific diagnostic modality because of overlapping features upon physical examination or a tumor-like appearance from the radiological examination, the more reason for triple diagnosis to be performed for an exact diagnosis. Â We report 5 cases of fractures tumor-mimicking lesions. The First patient, a patient with MRI revealing a primary malignant bone tumor, but with plain thorax x-ray and FNAB, the diagnosis was tuberculosis arthritis of the elbow. The second patient shows metastatic proses with plain radiographic, but from open biopsy, the diagnoses fall to chronic osteomyelitis. The third patient had a history of papillary carcinoma thyroid with pathological fracture of proximal of the left femur, but the biopsy shows a hypercalcemic state. The fourth patient, had mass size 20x15 cm at the thigh, but the biopsy shows Non-Specific Chronic Osteomyelitis. The fifth patient with progressive swelling of the left knee for one year, 10x10 cm in size, the biopsy showed no sign of malignancy but tuberculosis of left distal femur. In conclusion, standard comprehensive diagnosis steps consisting of clinical history, imaging, laboratory and histopathological examinations are crucial to differentiate tumor-mimicking lesions from neoplasms, thus ensuring proper treatment.
Keywords: Tumour mimicking, osteosarcoma, chondroma, malignancy
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References
Binesh, F., Sobhan, M., Moghadam, R. N., & Akhavan, A. (2013). Exuberant callus formation misdiagnosed as osteosarcoma: a case report. The Chinese-German Journal of Clinical Oncology, 12(3), 137–139. https://doi.org/10.1007/s10330-012-1080-z
Dirschl, D. R., & Almekinders, L. C. (1993). Osteomyelitis. Drugs, 45(1), 29–43. https://doi.org/10.2165/00003495-199345010-00004
Gersch, R. P., Lombardo, F., McGovern, S. C., & Hadjiargyrou, M. (2005). Reactivation of Hox gene expression during bone regeneration. Journal of Orthopaedic Research, 23(4), 882–890. https://doi.org/10.1016/j.orthres.2005.02.005
Hoch, B., & Montag, A. (2011). Reactive bone lesions mimicking neoplasms. Seminars in Diagnostic Pathology, 28(1), 102–112. https://doi.org/10.1053/j.semdp.2011.02.011
Huang, P.-Y., Wu, P.-K., Chen, C.-F., Lee, F.-T., Wu, H.-T., Liu, C.-L., … Chen, W.-M. (2013). Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases. World Journal of Surgical Oncology, 11(1), 283. https://doi.org/10.1186/1477-7819-11-283
Kim, S. Y., Park, J. S., Ryu, K. N., Jin, W., & Park, S. Y. (n.d.). Various tumor-mimicking lesions in the musculoskeletal system: causes and diagnostic approach. Korean Journal of Radiology, 12(2), 220–231. https://doi.org/10.3348/kjr.2011.12.2.220
Madewell, J. E., Ragsdale, B. D., & Sweet, D. E. (1981). Radiologic and pathologic analysis of solitary bone lesions. Part I: internal margins. Radiologic Clinics of North America, 19(4), 715–748. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7323290
Miller M. (2012). Review of Orthopaedics (6th ed.). Virginia: Saunders.
Rahardjo P, Utomo SA. (1998). Imejing Diagnostik Tumor Tulang. In Abdurrahman (Ed.), Penanganan Terpadu Tumor Muskuloskeletal. Surabaya: Universitas Airlangga.
Salter RB. (1999). Textbook of Disorders and Injuries of the Muskuloskeletal Sistem (3rd ed.). Baltimore, MD: Williams & Wilkins.
Shimose, S., Sugita, T., Kubo, T., Matsuo, T., Nobuto, H., & Ochi, M. (2008). Differential diagnosis between osteomyelitis and bone tumors. Acta Radiologica, 49(8), 928–933. https://doi.org/10.1080/02841850802241809
Solomon L, Warwick D, N. S. (2010). Apley’s System of Orthopaedics and Fractures (9th ed.). London: Hodder Arnold.
Ward WG, Corey RM, Watkins-Castillo SI. (2014). United States Bone and Joint Initiative: The Burden of Muskuloskeletal Diseases in the United States. Rosemont, IL.
Authors
Qanun Medika by FK UM Surabaya is liscence under Lisensi Creative Commons Atribusi 4.0 Internasional.