原发性或转移性骨肿瘤易误诊为原发性骨质疏松症

Primary Bone and Metastatic Bone Neoplasm Misdiagnosed as Primary Osteoporosis

目的探讨原发性骨肿瘤及转移性骨肿瘤与原发性骨质疏松症的临床特点,以减少误诊误治。方法回顾分析我科2010年9-10月收治5例原发性骨肿瘤及转移性骨肿瘤误诊为原发性骨质疏松症的临床资料。结果本组5例均有不同程度的疼痛、乏力、食欲减退、体重减轻。1例伴腰椎压缩性骨折,1例在1年内先后左腕、右踝及左胫骨骨折。均在外院首诊为骨质疏松症,入我院后经完善医技检查最终确诊为肺腺癌骨转移3例,多发性骨髓瘤、前列腺癌骨转移各1例。结论恶性肿瘤和骨质疏松症均是中老年人常见疾病,两者鉴别困难。故在诊断原发性骨质疏松症前,应注重病史采集和体格检查,建立比较完整的排除诊断项目,以降低原发性骨肿瘤及转移性骨肿瘤的误诊率。

Objective To investigate the clinical features of primary bone and metastatic bone neoplasm and to reduce misdiagnosis.Methods The clinical data of 5 cases of primary and metastatic bone neoplasm misdiagozed as primary osteoporosis during September～October in 2010 were respectively analyzed.Results 5 patients had varying degrees of pain,weakness,lossing of appetite and weight.1 case had left wrist,right ankle and left tibia fracture in one year.First diagnosed as osteoporosis in other hospitals,all patients underwent underwent final examination and were confirmed of bone metastases of lung cancer in 3 cases,multiple myeloma in 1 case and prostate cancer bone metastasis in 1 case.Conclusion Cancer and osteoporosis are common diseases in the elderly and both are difficult to distinguish.Therefore,before diagnosis of osteoporosis,we should pay attention to history taking and physical examination to establish a more comprehensive diagnosis of exclusion projects and reduce misdiagnosis rate of primary and mestastatic bone neoplasm.