肺癌骨转移所致腰腿麻痛的误诊原因(附1例报告并文献复习)

Analysis on Reason for Misdiagnosis of Back and Leg Pain Caused by Osseous Metastasis from Lung Cancer

目的分析肺癌骨转移引起腰腿痛症状导致误诊的原因及教训。方法对1例误诊为腰椎间盘突出症、腰臀部慢性软组织损害的肺癌骨转移致腰腿痛患者的诊疗过程结合文献进行综合分析。结果肺癌骨转移所致腰腿麻痛症状是因受累椎体发生溶骨性破坏或楔形变,对应椎管位置狭窄,肿瘤侵犯骨皮质或软组织肿块压迫刺激脊髓和神经根而引起,本病误诊的主要原因是病史询问不详,查体简单、粗疏,未做针对性强的影像学检查。结论仔细询问病史,认真查体,与早期行针对性强的影像学检查相结合,可有效降低误诊率。

Objective To analyze the reason for misdiagnosis of back and leg pain caused by osseous metastasis from lung cancer,and investigate how to avoid it.Methods One lung cancer patient with osseous metastasis was misdiagnosed as lumbar intervertebral disc protrusion,and we carried out the comprehensive analysis via the retrospection of its diagnostic and therapeutic course plus the related literature.Results Osteolysis or wedging occurred in the involved vertebral body,the corresponding spinal was stenosed,and the spinal cord or nerve root was irritated.All these led to the patient＇s back and leg pain,and then to the misdiagnosis.Conclusion It is suggested that careful case history gathering and physical examination helps to lowering the misdiagnosis of osseous metastasis resulting from lung cancer in patients with pain in back or leg in addition to the location by imaging detection.