Avoiding diagnostic pitfalls in mimics of neoplasia: the importance of a comprehensive diagnostic approach

Singapore Med J. 2015 May;56(5):e92-5. doi: 10.11622/smedj.2015082.

Abstract

Any medical diagnosis should take a multimodal approach, especially those involving tumour-like conditions, as entities that mimic neoplasms have overlapping features and may present detrimental outcomes if they are underdiagnosed. These case reports present diagnostic pitfalls resulting from overdependence on a single diagnostic parameter for three musculoskeletal neoplasm mimics: brown tumour (BT) that was mistaken for giant cell tumour (GCT), methicillin-resistant Staphylococcus aureus osteomyelitis mistaken for osteosarcoma and a pseudoaneurysm mistaken for a soft tissue sarcoma. Literature reviews revealed five reports of BT simulating GCT, four reports of osteomyelitis mimicking osteosarcoma and five reports of a pseudoaneurysm imitating a soft tissue sarcoma. Our findings highlight the therapeutic dilemmas that arise with musculoskeletal mimics, as well as the importance of thorough investigation to distinguish mimickers from true neoplasms.

Keywords: diagnosis errors; musculoskeletal; neoplasms; tumour-like conditions.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, False / diagnosis
  • Biopsy
  • Bone Diseases / diagnosis*
  • Bone Diseases, Metabolic / diagnosis
  • Bone Neoplasms / diagnosis
  • Cell Proliferation
  • Diagnosis, Differential*
  • Diagnostic Errors / prevention & control
  • Female
  • Giant Cell Tumors / diagnosis
  • Humans
  • Hyperparathyroidism / complications
  • Leukocytosis / diagnosis
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Middle Aged
  • Neoplasms / diagnosis*
  • Neoplasms / microbiology
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / microbiology
  • Osteosarcoma / diagnosis
  • Sarcoma / diagnosis
  • Soft Tissue Neoplasms / diagnosis
  • Tibia / pathology