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[Osteonecrosis, metastases and bronchial carcinoid]
1Service de Gérontologie Clinique, Hôpital Paul-Brousse, Villejuif.
Revue Du Rhumatisme Et Des Maladies Osteo-Articulaires
|February 1, 1992
Summary
A rare bronchial carcinoid tumor metastasized to the spine, initially misdiagnosed as osteonecrosis. Subsequent biopsies revealed the metastasis, highlighting diagnostic challenges in spinal carcinoid deposits.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Bronchial carcinoid tumors are rare neuroendocrine neoplasms.
- Metastasis from bronchial carcinoid tumors is uncommon, particularly to bone.
- Distinguishing bone metastases from primary bone lesions can be diagnostically challenging.
Observation:
- A 35-year-old woman with a history of bronchial carcinoid tumor developed liver metastases.
- An asymptomatic D10 vertebral lesion was initially suspected to be osteonecrosis based on CT and NMR.
- After 2 years, spinal pain prompted repeat investigations; biopsy confirmed carcinoid metastasis, not osteonecrosis.
Findings:
- The vertebral lesion, initially mimicking osteonecrosis, was histologically confirmed as a carcinoid tumor metastasis.
- Bone metastases from carcinoid tumors are typically osteoblastic and often axial.
- The patient's lesion shared features with idiopathic bone infarcts or those seen in Gaucher's or sickle cell disease.
Implications:
- This case underscores the importance of considering metastatic disease in patients with a history of carcinoid tumors, even with atypical presentations.
- The findings highlight the potential for misdiagnosis of spinal metastases as primary bone conditions like osteonecrosis.
- Further research is needed to elucidate the relationship between vertebral necrosis and carcinoid metastasis.