宫颈癌放疗后骨盆不全骨折误诊分析
Analysis of Misdiagnosis of Pelvic Insufficiency Fracture after Radiotherapy for Cervical Cancer
张燚 1张建军1
作者信息
- 1. 050082 石家庄,解放军联勤保障部队第九八○医院放疗科
- 折叠
摘要
目的 探讨宫颈癌放疗后骨盆不全骨折(PIF)的诊治措施及误诊原因、防范措施.方法 回顾性分析2020 年1 月—2022 年12 月收治的误诊为骨转移癌的宫颈癌放疗后PIF 3 例的临床资料.结果 本组 3 例均因宫颈癌放疗后出现腰骶部疼痛就诊,MRI和SPET/CT等影像学检查提示骨转移癌,建议行局部放疗,1 例 1 个月后经术后病理检查确诊PIF,经相应治疗症状缓解;2 例经对症治疗症状缓解,随访 1 年影像学复查未见进展诊断为PIF.结论 临床和影像学表现缺乏特异性和接诊医生诊断经验不足是导致宫颈癌放疗后PIF误诊的主要原因.对宫颈癌放疗后出现骨盆疼痛患者需综合临床表现及多种影像学检查结果进行诊断,特别要注意与骨转移癌鉴别,以避免误诊.
Abstract
Objective To investigate the diagnosis and treatment,causes of misdiagnosis and preventive measures of pelvic insufficiency fracture(PIF)after radiotherapy for cervical cancer.Methods The clinical data of 3 patients with cervi-cal cancer and PIF after radiotherapy misdiagnosed as bone metastases admitted from January 2020 to December 2022 were ret-rospectively analyzed.Results All 3 cases presented with lumbosacral pain after radiotherapy for cervical cancer.MRI,SPET/CT and other imaging examinations suggested bone metastases,and local radiotherapy was recommended.One patient was diagnosed with PIF by postoperative pathological examination one month later,and the symptoms were relieved by corre-sponding treatment.The symptoms of 2 patients were relieved by symptomatic treatment,no progression was found in imaging review at 1-year follow-up,and diagnosis of PIF was made.Conclusion The main causes of misdiagnosis of PIF after radio-therapy of cervical cancer are the lack of specificity of clinical and imaging findings and the inexperience of clinicians.The pa-tients with pelvic pain after radiotherapy of cervical cancer should be diagnosed by comprehensive clinical manifestations and va-rious imaging findings,especially the differentiation from bone metastatic cancer to avoid misdiagnosis and mistreatment.
关键词
宫颈肿瘤/放射疗法/骨折/骨盆/误诊/骨转移癌/影像学/病理Key words
Uterine cervical neoplasms/Radiotherapy/Bone fractures/Pelvis/Misdiagnosis/Bone metastatic canc-er/Imaging/Pathology引用本文复制引用
出版年
2023
国家科技期刊平台
NSTL
万方数据