Background/Purpose: Metastatic deposits in bones increase overall morbidity in cancer patients. The orthopaedic oncologist aims at controlling the skeletal morbidity as a way of reducing the overall morbidity in the survival period of the cancer patient. This study investigated the characteristics of metastatic extremity bone tumours requiring surgical treatment, with a view to setting a template for a local database of extremity metastatic bone tumours in Hong Kong. Methods: A retrospective review of metastatic extremity bone tumours treated surgically at a university hospital in Hong Kong, from January 2006 to December 2015, is presented. Results: In total, 126 patients were studied. The lung (28.6%) was the most common source of metastasis to the extremity bones. The femur (70.1%) was most commonly involved. Pathological fractures (47.4%) were the most common indications for surgery. Intramedullary nailing (57.3%) was the most common surgical treatment. The overall postoperative complication rate was 8.7%. The mean duration of follow-up was 10.8 ± 4.1 months. Furthermore, 79.4% of the patients died within the study period, with mean duration of postoperative survival of 6.1 ± 1.1 months. Spinal compression (p ¼ 0.001), indication for surgery (p ¼ 0.001), age of the patient (p ¼ 0.001), and option of surgical treatment (p ¼ 0.000319) were found to have significantly affected the duration of postoperative survival. Conclusion: The surgical management of extremity bone metastasis is a key consideration in averting potentially crippling morbidity. Options of treatment need be carefully chosen in appropriate patients for a good outcome. 中 文 摘 要 背景: 腫瘤的骨轉移增加了癌症患者的病況。骨科腫瘤學家旨在控制骨骼的病況來降低癌症病人的總病態。 這項研究調查需要手術治療的轉移性肢端骨腫瘤的特點,以便建立香港的轉移性肢端骨腫瘤的本地數據庫模 板。 方法: 回顧性研究由2006年1月至2015年12月在一所香港大學醫院手術治療的轉移性肢端骨腫瘤個案。 結果: 共有126例患者進行了研究。肺部(28.6%)是最常見轉移到肢體骨骼的來源。股骨(70.1%)是最常見 出現骨轉移的位置。病理性骨折(47.4%)是最常見的手術適應症。髓內釘(57.3%)是常見的手術治療方 法。整體術後併發症發生率為8.7%。平均隨訪時間為10.8 ± 4.1個月。79.4%的患者在研究期內死亡,平均術 後生存期為6.1 ± 1.1個月。脊柱壓迫(P值 ¼ 0.001
Tuberculosis is a mycobacterial infection, but it can mimic many diseases including diseases of the musculoskeletal system. The need to consider it as a differential diagnosis of musculoskeletal tumours and tumour-like conditions cannot be overemphasized. The opinions of some, that tuberculosis is a disease of the undeveloped world, can no longer be sustained especially in the presence of immunodeficiency disorders, including HIV/AIDS, which have a worldwide prevalence. Traditionally, literature evidence shows that tuberculosis can mimic quite a number of diseases, including cancers. This has been found to be true, even in some technologically advanced countries. We present a case of hepatocellular cancer patient incidentally found to have concomitant hepatic tuberculosis who complained of bone lesion, with clinico-radiologic features of metastasis, but which turned out to be a tuberculous infection of the bone.
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