Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Tumours
Abstract number: 25490
DIAGNOSTIC DELAY IN BONE METASTASIS FROM OCCULT MALIGNANCY
Yasuyuki KITAGAWA 1 , Yoko ISHIHARA 2 , Mikihiko HAYASHI 2 , Yong KIM 1 , Nobuhito
FUJII 2 , Hiromoto ITO 3
1 Dept. of Orthopaedic Surgery, Tamanagayama Hospital, Nippon Medical School,
Tokyo (JAPAN), 2 Dept of Orthopaedic Surgery, Tamanagayama Hospital, Nippon
Medical School, Tokyo (JAPAN), 3 Dept of Orthopaedic Surgery, Nippon Medical
School, Tokyo (JAPAN)
INTRODUCTION: Bone metastasis is a serious condition. When it occurs without a
history of any other malignancy, it is not easily differentiated from spondylosis
deformans or osteoporotic fracture, which could delay the commencement of
treatment. We reviewed our patients to determine the delay in diagnosis and to
investigate useful examinations for diagnosis, which could help to shorten the
delay.MATERIALS AND METHODS: A retrospective review of 29 consecutive
patients with bone metastasis without a history of any other malignancy was
undertaken. The period before diagnosis was evaluated. It was classified as the
period from the onset of symptoms to the first visit to a doctor (the first period) and
the period from the first visit to a doctor to the diagnosis of bone metastasis (the
second period). RESULTS: The diagnosis of bone metastasis was made at the first
visit for only 3 patients. The medians of the first and second periods were 2 and 7
week, respectively. These periods had no relationships with age, gender, metastatic
site, or primary site. The examination method that was basis of the diagnosis of bone
metastasis was MRI in 16 patients, and the reason why the examination was carried
out was aggravation of symptoms in 18 patients. DISCUSSION: This study
suggested that early diagnosis of bone metastasis in patients without a history of any
other malignancy is not easy. It also suggested that early recognition of aggravation
and the use of further examination method such as MRI are important for the early
diagnosis.
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