title: Avoiding diagnostic pitfalls in mimics of neoplasia: the importance of a comprehensive diagnostic approach.
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.
authors.affiliation: Clinical Investigation Centre, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Ely Zarina
authors.initials: EZ
authors.lastname: Samsudin
authors.affiliation: Clinical Investigation Centre, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Tunku
authors.initials: T
authors.lastname: Kamarul
authors.affiliation: National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Azura
authors.initials: A
authors.lastname: Mansor
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis; D001706:Biopsy; D001847:Bone Diseases / Q000175:diagnosis*; D001851:Bone Diseases, Metabolic / Q000175:diagnosis; D001859:Bone Neoplasms / Q000175:diagnosis; D049109:Cell Proliferation; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D005870:Giant Cell Tumors / Q000175:diagnosis; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications; D007964:Leukocytosis / Q000175:diagnosis; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000382:microbiology; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology; D012516:Osteosarcoma / Q000175:diagnosis; D012509:Sarcoma / Q000175:diagnosis; D012983:Soft Tissue Neoplasms / Q000175:diagnosis; D013977:Tibia / Q000473:pathology
keywords: diagnosis errors; musculoskeletal; neoplasms; tumour-like conditions