临床误诊误治2025，Vol.38Issue(1)：21-24,4.DOI:10.3969/j.issn.1002-3429.2025.01.006
腰椎管肿瘤临床误诊探析
Analysis of Clinical Misdiagnosis of Lumbar Spinal Canal Tumors
摘要
Abstract
Objective To analyze the causes of clinical misdiagnosis of lumbar spinal canal tumors.Methods From February 2022 to February 2023,the clinical data of 2 patients with lumbar spinal canal tumor who were initially diagnosed with lumbar disc herniation were retrospectively analyzed.Results A case of lower limb pain and numbness with lumbar pain for 6 months was considered to have lumbar disc herniation according to clinical symptoms,signs and CT examination of lum-bar spine.Comprehensive conservative treatment was ineffective.After lumbar magnetic resonance imaging(MRI)and surgi-cal pathological examination,it was confirmed to be lumbar intraspinal hemangilymphangioma.The misdiagnosis lasted 91 d.No recurrence was observed at 1-year follow-up.A case presented with recurrent low back pain accompanied by weakness of lower limbs for more than 1 month.Based on clinical symptoms,signs and lumbar X-ray examination,the initial diagnosis was lumbar disc herniation,and the symptoms showed progressive aggravation after conservative treatment.Considering the patient's long history of smoking,lumbar MRI,whole-body PET-CT examination,bronchoscopic biopsy,and surgical patholo-gy confirmed that the patient had metastasis of lung cancer to lumbar spinal canal.The misdiagnosis lasted 35 d.After postop-erative adjuvant chemoradiotherapy,during the follow-up period of 1 year,the primary lung lesions continued to shrink,no new metastases were found,and the patient had good quality of life.Conclusion In clinical practice,for patients with lower back pain,leg pain and lower limb numbness who had poor results after symptomatic treatment for lumbar disc herniation,vig-ilance should be increased,attention should be paid to differentiation from lumbar canal tumors,and MRI should be performed as soon as possible,thereby reducing the misdiagnosis rate.关键词
肿瘤/椎管/误诊/椎间盘移位/磁共振成像/病理/诊断Key words
Neoplasms/Spinal canal/Misdiagnosis/Intervertebral disc displacement/Magnetic resonance imaging/Pathology/Diagnosis分类
临床医学引用本文复制引用
姚光伟,何昌隆,张韬,薛朝亚..腰椎管肿瘤临床误诊探析[J].临床误诊误治,2025,38(1):21-24,4.基金项目
秦皇岛市重点研发计划科技支撑项目(20210A119) （20210A119）
