Frequency Of Diagnostic Errors Research Articles

Is work overload associated with diagnostic errors on 18F-FDG-PET/CT?

To determine the association between workload and diagnostic errors on 18F-FDG-PET/CT. This study included 103 18F-FDG-PET/CT scans with a diagnostic error that was corrected with an addendum between March 2018 and July 2023. All scans were performed at a tertiary care center. The workload of each nuclear medicine physician or radiologist who authorized the 18F-FDG-PET/CT report was determined on the day the diagnostic error was made and normalized for his or her own average daily production (workloadnormalized). A workloadnormalized of more than 100% indicates that the nuclear medicine physician or radiologist had a relative work overload, while a value of less than 100% indicates a relative work underload on the day the diagnostic error was made. The time of the day the diagnostic error was made was also recorded. Workloadnormalized was compared to 100% using a signed rank sum test, with the hypothesis that it would significantly exceed 100%. A Mann-Kendall test was performed to test the hypothesis that diagnostic errors would increase over the course of the day. Workloadnormalized (median of 121%, interquartile range: 71 to 146%) on the days the diagnostic errors were made was significantly higher than 100% (P = 0.014). There was no significant upward trend in the frequency of diagnostic errors over the course of the day (Mann-Kendall tau = 0.05, P = 0.7294). Work overload seems to be associated with diagnostic errors on 18F-FDG-PET/CT. Diagnostic errors were encountered throughout the entire working day, without any upward trend towards the end of the day.

Diagnostic odyssey of Guillain-Barré syndrome in children

Background and ObjectivesA gap exists between difficulty in diagnosis and importance of early recognition and intervention in pediatric Guillain-Barré syndrome (GBS). Therefore, this study aimed to establish a diagnostic odyssey plot that allows “at-a-glance” overview of the diagnostic odyssey of GBS in children, including overall diagnostic delay, physician-related and patient-related diagnostic delays, and length and frequency of diagnostic errors. MethodsIn this single-center retrospective cohort study, standardized data were obtained from children with GBS from 2003 to 2020. Overall diagnostic delay (time between symptom onset and diagnosis), physician-related diagnostic delay (time between the first medical visit and diagnosis), and patient-related diagnostic delay (time between symptom onset and the first medical visit) were analyzed. ResultsThe study examined a total of 21 patients (11 men, median age 4.5 years). Overall, there were 40 misdiagnoses among 17 patients, while four were diagnosed correctly at the first visit. The overall diagnostic delay was 9 days [interquartile range (IQR), 6–17 days]. Physician-related diagnostic delay, but not patient-related diagnostic delay, was correlated with the overall diagnostic delay. Patients in the late-diagnosed group were more frequently misdiagnosed during their diagnostic odyssey than patients in the other groups. Risk factors associated with diagnostic delay included delayed onset of weakness and sensory deficits, absence of swallowing problems, and misdiagnosis as orthopedic disorders or viral infections. DiscussionA unique diagnostic odyssey exists in pedaitric GBS. Several clinical risk factors were associated with the diagnostic delay.

Diagnostic Errors: Association with level of expertise, effect of time taken to reach the diagnosis and utilization of differential diagnosis checklists among postgraduate trainees.

The objectives of this study were to evaluate: (1) The association between level of training (expertise) and rate of diagnostic errors. (2) The effect of time taken to reach a diagnosis on the frequency of diagnostic errors. (3) The effect of utilization of differential diagnosis checklists in reducing the frequency of diagnostic errors. The study was carried out from November 2020 till April 2021 in Peshawar. The participants included FCPS Part-II trainees of Maxillofacial Surgery undergoing training in five centres. Thirty written case scenarios were prepared and validated, ten scenarios for each of the three objectives. To evaluate the association between training level (expertise) and the rate of diagnostic errors, two groups of trainees (1st year group and 4th year group) were formed and given ten same case scenarios for diagnosis. To evaluate the effect of time taken to reach diagnosis on the frequency of diagnostic errors, two groups of 4th year trainees (fast group and slow group) were formed by random allocation of participants to groups and given ten similar case scenarios for diagnosis. Fast group was given 15-minutes whereas slow group was given 30-minutes to respond. To evaluate the effect of utilization of differential diagnosis checklists in reducing diagnostic errors, again two groups of 4th year trainees were formed by random allocation of participants to groups and given ten similar case scenarios for diagnosis. One group was given differential diagnosis checklists for the scenarios and the other none. In this study, participants included were 1st year (n=36) and 4th year (n=36) trainees of Maxillofacial Surgery. The results showed that training level or expertise was significantly associated with the rate of diagnostic errors (p = 0.002). Time taken to reach diagnosis and differential diagnosis checklists have no significant effect on the frequency of diagnostic errors (p = 0.74 and 0.56 respectively). Training level (expertise) has significant effect on the frequency of diagnostic errors whereas no significant effect was recorded for time (time taken to reach diagnosis) and differential diagnosis checklists on the rate of diagnostic errors.

Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study.

To determine the frequency and etiology of diagnostic errors during the first 7 days of admission for inborn neonatal intensive care unit (NICU) patients. We conducted a retrospective cohort study of 600 consecutive inborn admissions. A physician used the "Safer Dx NICU Instrument" to review the electronic health record for the first 7 days of admission, and categorized cases as "yes," "unclear," or "no" for diagnostic error. A secondary reviewer evaluated all "yes" charts plus a random sample of charts in the other categories. Subsequently, all secondary reviewers reviewed records with discordance between primary and secondary review to arrive at consensus. We identified 37 diagnostic errors (6.2% of study patients) with "substantial agreement" between reviewers (κ = 0.66). The most common diagnostic process breakdown was missed maternal history (51%). The frequency of diagnostic error in inborn NICU patients during the first 7 days of admission is 6.2%.

Plasma cell tumors of the head and neck. Analysis of diagnostic difficulties based on literature and own data

Background. Extramedullary plasmacytoma (EP) of soft tissues, which in most cases affects the organs of the head and neck region, is a relatively rare malignant tumor. Until now, there are no consensus approaches to the diagnosis and treatment of EP. Differentiating EP from other types of non-Hodgkin’s lymphomas is difficult. There are difficulties in the differential diagnosis of EP and carcinomas in the head and neck region. Given the rare occurrence of this nosological form, the frequency of diagnostic errors is quite high, which dictates the need for a thorough description of each head and neck EP case.Objective of the study: analysis of possible difficulties and reasons for incorrect interpretation of diagnostic data, and treatment for head and neck EP.Materials and methods. Clinical and morphoimmunological data of 97 primary patients with B-cell non-Hodgkin’s lymphomas (B-NHLs) of the head-neck region were analyzed.Results. In our cohort we identified 2 tumor cases of a plasma cell nature, which amounted to 2 % among all B-NHLs. In one case, the process was located in the nasal cavity and clinically manifested itself with nosebleeds. The second case is a lesion of the mouth floor, primarily with the ulcer formation. In the first cases, at diagnosis, the immunohistochemistry (IHC) test was performed after patient’s chemotherapy and radiation treatment, which distorted the tumor immunophenotype. In the second cases with extensive process in maxillary sinuses, a complete and very detailed IHC test was carried out; however the data did not allow for a definitive diagnosis. Difficulties apparently arose in the interpretation of CD38 expression – main marker of plasmacytic line cells, as well as due to the unusual morphology.Conclusion. The described diagnostic situations dictate the need for a comprehensive algorithm in the diagnosis of head and neck tumors. It is advisable to perform an extended morpho-immunophenotypic study of the tumor (IHC, immunocytology, flow cytometry, etc.), if a tumor of a plasma cell nature is suspected, a morpho-immunological study of the bone marrow is indicated.

CONTRAST-ENHANCED COMPUTED TOMOGRAPHIC CHOLANGIOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF THE MALIGNANT AND BENIGN CAUSES OF BILIARY OBSTRUCTION

Introduction. Determination of the cause of cholestasis and treatment of patients with obstructive jaundice syndrome remains challenging owing to the steady rise in diseases of the hepatopancreatoduodenal zone and the high frequency of diagnostic errors. In the differential diagnosis of the causes of obstructive jaundice, diagnostic imaging techniques are of the greatest importance. In the world literature, there are few reports on the assessment of the diagnostic potential of multispiral computed tomography under conditions of direct contrasting of the biliary tree using endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, or through pre-installed palliative drainage in the bile ducts. There is no generally accepted algorithm for determining the causes of biliary obstruction. It leads to ineffective use of various diagnostic imaging techniques, complicating the diagnostic process.The purpose of the study was to evaluate the diagnostic efficacy of contrast-enhanced ct cholangiography (ct-cg) in the differential diagnosis of causes of malignant and benign biliary obstruction in cases with obstructive jaundice syndrome.Material and methods. The study included 55 patients with obstructive jaundice, who were treated in a surgical hospital from july 2016 to july 2019.Results. It was found that contrast ct-cg in diagnosing the causes of biliary obstruction of both malignant and benign genesis is more informative than x-ray endoscopic retrograde cholangiopancreatography. The diagnostic efficacy of ct-cg in detecting causes of malignant biliary obstruction was: 93.3% sensitivity, 92.9% specificity, and 93.1% accuracy. The diagnostic efficacy of ct-cg in detecting causes of benign biliary obstruction was: 92.9%, 93.3% and 93.1%, respectively.Conclusion. Based on the high accuracy, contrast-enhanced ct-cg is a promising imaging technique in cases with bile duct obstruction.

Роль ультразвукової еластографії зсувної хвилі в діагностиці аденоміоза та/або гіперпластичних процесів ендометрія

Today, hysteroscopy, ultrasound and magnetic resonance imaging are most often used in clinical practice for the diagnosis of adenomyosis. However, the high frequency of diagnostic errors (from 20 to 40%), depending on the experience of the operator and equipment, detailing the structure of the myometrium and the parameters of ultrasound differentiation of adenomyosis, requires the search for new optimal diagnostic methods. The purpose of our study was to determine the parameters of ultrasound elastography of the shear wave in patients with adenomyosis and / or hyperplastic processes of the endometrium. Material and methods. The study included 128 patients aged from 27 to 53 years (mean 39.4 ± 8.6). The first group included 38 (29.6%) patients diagnosed with grade I-II adenomyosis, the second group had 41 (32.1%) patients with a combination of grade I-II adenomyosis with endometrial hyperplastic processes and / or uterine leiomyoma, the third group consisted of 39 (30.5%) women only with hyperplastic processes of the endometrium. The control fourth group included 10 (7.8%) women without endometrial pathology, who sought women's advice on primary infertility. Results and discussion. When performing shear wave elastography, significant differences in the color of myometrial mapping were found between patients of the first, third and control groups (p <0.001). Unchanged myometrium in all patients of the control group was represented by shades of blue, and the staining was uniform in 9 (90%) subjects. In patients of the first group, the myometrium was stained with shades of red in 31 (81.63%) cases and shades of yellow in 3 (7.8%) cases; in 23 (60.5%) cases there was inhomogeneous red staining and in 14 (36.8%) cases staining was inhomogeneous in shades of red-yellow-light blue. When performing elastography in patients of the second group in the projection of the myoma was more often detected staining in shades of red in 20 (48.8%) cases, yellow in 6 (14.6%) and light blue in 3 (7.3%) cases; in 28 (68.3%) cases there was inhomogeneous red staining and in 19 (46.3%) cases staining was inhomogeneous in shades of red-yellow-light blue. In the third group in the projection of the leiomatous node was more often determined by staining in shades of red in 22 (56.4%) cases, yellow in 8 (20.5%) and light blue in 6 (15.4%) cases, colors on the background of the blue myometrium; inhomogeneous staining of myomatous nodes was detected in 31 (79.5%), and homogeneous staining was in 7 (17.9%) cases. Unchanged myometrium in the control group was characterized by significantly lower values of the Young's modulus 25.2 (17.9-34.1 kPa), while in the group of adenomyosis the average value of Emean reached 71.8 (17.9-281.3 kPa), was maximally high and significantly different from the indicators of the control group and from the indicators of group 3 patients 29.6 (13.5-58.9 kPa). The rates of patients of the second group, in whom grade I-II adenomyosis was combined with endometrial hyperplastic processes and / or uterine leiomyoma 54.7 (15.6-133.9 kPa) were also significantly higher than the values of the control group and the third group. Conclusion. Shear wave ultrasound is a minimally invasive and accessible method of high-quality preoperative diagnosis, necessary to avoid hysterectomy and clarify the diagnosis without surgery, which is recommended for use in practice to improve the accuracy of diagnosis of adenomyosis

Shades of grey: how and why we make mistakes

Purpose: to consider the epidemiology and classification of errors in radiologic diagnostics.Materials and methods. The analysis of articles devoted to elucidating the possible causes of diagnostic errors published before 2019 is carried out. A retrospective analysis of the research results revealed the most frequent cognitive biases affecting clinical decision making. Strategies have been developed to combat these distortions, which minimize the likelihood of errors.Discussion. Image analysis by doctors is a complex work based on a combination of psychophysiological and cognitive processes, which in itself is subject to a wide variety of errors, including perception errors (when pathological changes are simply skipped) and cognitive errors (those cases when pathological changes are detected visually but incorrectly interpreted). Although some of the changes in the radiation images may be skipped due to technical or physical limitations of the modality (resolution, signal-to-noise ratio, artifacts, etc.), most diagnostic discrepancies are associated with an incorrect interpretation of the findings by radiologists.Conclusions. Cognitive distortions can significantly affect the process of making diagnostic decisions, and lead to medical errors and negative consequences for patients. Various cognitive strategies and metacognitive practices can help minimize the impact of bias on decision making and reduce the frequency of diagnostic errors. Knowing one’s limitations and possibilities in interpreting radiation research, as well as understanding the role of the radiologist in the formation of the final diagnosis and, accordingly, in the fate of the patient, can lead to a more thoughtful analysis of images and clinical information and improve the quality of the diagnostic decision-making process.

Modern imaging modalities for diseases associated with obstructive jaundice syndrome

Obstructive jaundice (OJ) is a syndrome characterized by bile staining of the skin, mucous membranes, and sclera as a complication of pathological processes that lead to disruption of the bile ducts at various levels of the biliary tract. Obstructive jaundice represents various diseases with different onset, course, and outcome, as well as etiology, which implies the difficulties of the diagnostic process. Identification of a cholestasis cause and treatment of patients with OJ remain urgent and difficult tasks due to the steady rise in diseases of the hepatopancreatoduodenal zone (HPDZ) and the high frequency of diagnostic errors. The latter can lead to the progression of liver failure, as well as to the development of severe complications, which, in turn, are fatal. A significant role in detecting HPDZ pathology belongs to the radiological methods of studies, such as transabdominal ultrasonography (TUS), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), endoscopic ultrasound (EUS), intraductal ultrasonography (IDUS), magnetic resonance cholangiopancreatography (MRCP), helical computed tomography (hCT), and helical CT cholangiography (hCT-CG). However, it should be noted that, as of today, there is no well-established conventional radiological algorithm for determining the causes of biliary obstruction. This, in turn, leads to repeated or sequential inefficient administration of all possible methods of visualization, complicating the diagnostic algorithm. In this regard, it is advisable to perform an in-depth study of the Russian and foreign literature sources, highlighting the problem of an early and highly effective diagnostics of the causes of biliary obstruction in patients with OJ.

EXTENSIVE MAXILLOFACIAL LYMPHANGIOMA WITH SUPPURATION IN THE LATE POSTNATAL PERIOD OF A CHILD

Lymphangiomas have a dysontogenetic origin, that is, they occur during the development of the fetus and are treated as an abnormal development of the endothelium of proliferating lymphatic vessels and manifest clinically, most often immediately after the birth of a child or in infancy.
 According to data published earlier by the staff of our department, among benign tumors of soft tissues of maxillofacial area, dermoid cysts (32.6%) take first place. The second place is given to hemangiomas (26.0%); lymphangiosis of such localization are quite rare, accounting for only 3% of the total number of tumors of soft tissues of the face and neck, which causes certain features of tactical approaches to choice and scope of diagnostic measures. In general, lymphangioma, a malformation of the lymphatic system, accounts for 9% of all soft tissue germline tumors and is diagnosed immediately after birth in 65-85% of children, with their superficial location.
 When they are located in the maxillofacial region, aesthetic deficiencies or functional impairments can be quite pronounced. The features of their topographic-anatomical location in deep fiber spaces and in the area of the floor of the oral cavity cause considerable difficulties in the conduct of diagnostics, the choice of tactical operating techniques and methods of treatment, because the postoperative period is accompanied by a high probability of complications. The presented content of the medical history indicates that the diagnosis of deep-seated and bulky lymphangiomas in young children is rather difficult. Especially, when it comes to festering and combined with acute infectious somatic diseases, it can provoke the occurrence of the inflammatory process directly in the lymphangioma.
 Attention is drawn to the fact that the frequency of diagnostic errors at the prehospital stage is 75%. Basically, the children were sent to hospital with an incorrect diagnosis, although they were under the supervision of district pediatricians for a long time and repeatedly looked around at a pediatric surgeon.
 The purpose of our study was to study the peculiarities of clinical manifestations and the diagnosis of volumetric, deep-seated lymphangiomis of the maxillofacial focal infiltration in a child of infancy.
 Routine diagnostic methods, such as needle biopsy and modern computed tomography, make it possible to unify the diagnostic process to a great extent and decide on the optimal option for operative access and the volume of surgical intervention. There are also certain difficulties in the choice of pharmacological drugs and their dosage when it comes to the combination of a diffuse purulent process with acute manifestations of the pathology of infectious origin. This category of children is subject to dynamic observation to exclude the possibility of recurrence of lymphangioma in conditions of its incomplete necrotization with timely involvement of measures.

Tumors of thymus gland: clinical features, diagnosis, treatment

Main aspects of histogenesis, morphology and classification of tumors of the thymus, the current state of their diagnosis and treatment are submitted. Clinical manifestations of thymomas are dependent on their endocrine activity, pace and nature of growth, size and relationship with surrounding structures of mediastinum. Hormonal tumors of thymus are often accompanied by the development of generalized myasthenia gravis. Spiral computed and magnetic resonance tomography are recognized as the leading methods of diagnostics and differential diagnostics of the tumors of thymus gland. However, frequency of diagnostic errors can reach 10-30% of observations. The main method of treatment is surgical, as providing radical and the best long-term results. An adequate volume of surgical treatment of tumors of the thymus gland is thymomthymectomy- enblock removal of a tumor and the entire gland tissue along with fatty tissue and lymph nodes of anterior mediastinum. Various «open» and endovideosurgical approaches to thymus removal have been proposed. Minimally invasive endovideoscopic removal of thymus has a number of advantages over traditional, «open» thymectomy and is characterized by a much smaller intraoperative blood loss and duration of drainage of the pleural cavities, early activization of a patient and a shorter hospital stay. The implementation of endovideosurgical intervention is prescribed with the removal of thymoma I-II stage of cancer progression, as well as in some cases of combined operational benefits at stage III. However, international experience is not sufficient for making decisions regarding the selection of an optimal surgical approach in each case. In invasive tumors of thymus, combined treatment with the inclusion of radiation and chemotherapy is recommended. However, the choice of components of a treatment, modes and sequence remain controversial.

Diagnostic errors by medical students: results of a prospective qualitative study

BackgroundDiagnostic errors occur frequently in daily clinical practice and put patients’ safety at risk. There is an urgent need to improve education on clinical reasoning to reduce diagnostic errors. However, little is known about diagnostic errors of medical students. In this study, the nature of the causes of diagnostic errors made by medical students was analyzed.MethodsIn June 2016, 88 medical students worked on eight cases with the chief complaint dyspnea in a laboratory setting using an electronic learning platform, in summary 704 processed cases. The diagnostic steps of the students were tracked and analyzed. Furthermore, after each case the participants stated their presumed diagnosis and explained why they came to their diagnostic conclusion. The content of these explanations was analyzed qualitatively.ResultsBased on the diagnostic data gathering process and the students’ explanations, eight different causes could be identified of which the lack of diagnostic skills (24%) and inadequate knowledge base (16%) were the most common. Other causes that often contributed to a diagnostic error were faulty context generation (15%) and premature closure (10%). The causes of misdiagnosis varied per case.ConclusionsInadequate skills/knowledge and faulty context generation are the major problems in students’ clinical reasoning process. These findings are valuable for improving medical education and thus reducing the frequency of diagnostic errors in students’ later everyday clinical practice.

FEATURES OF COLON DIVERTICULOSIS LATE COMPLICATIONS SURGICAL TREATMENT

Diverticular disease of the colon is frequent bowel disease. Wide spread of this pathol- ogy, especially among elderly patients, is caused by characteristics of the diet in developed countries. In modern conditions the clinician is faced with the complicated forms of diverticular disease, in some cases requiring urgent surgical intervention. However, the frequency of diagnostic errors on the back- ground of complicated diverticular disease can reach significant values. A clinical case, indicating the significant difficulties, appearing while diagnosis and surgical treatment of diverticular disease late complications is exampled.

DISSEMINATED PULMONARY TUBERCULOSIS: ACTUAL PROBLEMS

In the structure of disseminated pulmonary diseases tuberculosis accounts for 3 to 35%, and in the structure of the newly diagnosed tuberculosis disseminated forms account for about one third of all cases. Differential diagnosis of the pulmonary dissemination syndrome is a problem for physicians of various specialties. The frequency of diagnostic errors can reach 80%. Aim - to review the literature on the diagnosis of disseminated pulmonary tuberculosis over the past 10 years and to identify actual issues on this problem for further study. Methods. We have done bibliographic search on the PubMed/Medline and Elibrary databases over the past 10 years (2007-2017).

Diagnostic Pitfalls in “Low-Grade Lymphoma” of the Orbit and Lacrimal Gland

Aims: To investigate potential diagnostic pitfalls associated with the identification of low grade lymphoma in the orbit and lacrimal gland region.Methods: To systemically review all cases diagnosed as low grade lymphoma of orbit and lacrimal gland within a 2 year period at a specialist ophthalmic centre. To ascertain the frequency of diagnostic errors in this group of cases, in particular to look for known pitfalls associated with follicular colonisation by marginal zone lymphoma and the recently identified atypical variant of follicular lymphoma (FL). A series of 21 cases were reviewed.Results: We identified two diagnostic errors; one case of extra nodal marginal zone lymphoma (ENMZL) which showed follicular colonisation and was misinterpreted as a FL and a case of missed mantle cell lymphoma (MCL). We identified no cases of atypical FL.Conclusion: Within the orbit and lacrimal gland the term “low grade lymphoma” encompasses the following types of lymphoma: ENMZL, FL, MCL and chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL). The typical and atypical immunophenotype of these entities is discussed. The diagnosis of ENMZL, by far the most common low grade lymphoma to occur in these areas, is to some extent a difficult diagnosis and is often one of exclusion. The pitfalls of follicular colonisation and the concept of atypical follicular lymphoma are discussed.

Difficult diagnosis. Clinical analysis of pneumonia overdiagnosis case.

Despite advances in modern medicine, the prevalence and mortality rates from pneumonia remain high, and the frequency of diagnostic errors ranges from 20 to 50%. This trend to increased morbidity and mortality heads the list in problems of early diagnosis, timely and adequate antibiotic therapy of pneumonia. The greatest attention is given to problems of pneumonia hypodiagnostics, while questions of its hyperdiagnostics, especially by narrow specialists, remain unaddressed. This article discusses the most common causes of pneumonia overdiagnosis at various stages of patients’ management, namely the evaluation of clinical symptoms, assess ment of radiological data and at the stage of additional diagnostic program. On the example of a clinical case, basic errors in diagnostic tactics in case of atypical course of cardiac pathology, which have led to the mistaken diagnosis of pneumonia are considered.

THE COURSE OF GOUTY ARTHRITIS ACCORDING TO THE KHABAROVSK CITY RHEUMATOLOGY ROOMAND THE EFFECTIVENESS OF GOUT SCHOOL

The past decade is marked by a rise in the detection rates of gout. The paper gives data on its incidence, risk factors, the frequency of diagnostic errors, the specific features of the course of male gouty arthritis, and the effectiveness of Gout school activities

Neurologic patient safety: An in-depth study of malpractice claims

This in-depth study of neurologic malpractice claims indicated authentic, preventable patient harm in 24 of 42 cases, enabling comparison with larger but administratively abstracted summary reports. Principal findings included the common occurrence of outpatient events, lapses in communication with patients and other providers, the need for follow-through by the consultant neurologist even when not primarily responsible, the frequency of diagnostic errors, and pitfalls associated with imaging.

Diagnosis of spinal tumors

A comparative analysis of the results was carried out at the Belarusian NIITO. Spinal tumors account for 12-18% of all skeletal neoplasms. Their diagnosis is extremely difficult, especially in the early stages. This is due to the polymorphism and vagueness of the clinical manifestations of spinal tumors in the initial period of the development of the process, with the variety of pathologies encountered. According to various authors, the frequency of diagnostic errors reaches 80%, their consequence is an increase in the number of neglected cases, inadequate treatment, which promotes tumor growth.

Spitz naevi misdiagnosed histologically as melanoma

A Spitz naevus is a benign melanocytic tumour that may histologically resemble a malignant melanoma. Data was retrospectively gathered from patients who attended the Victorian Melanoma Service to determine the prevalence of Spitz naevi pathologically misdiagnosed as melanoma. Assessment of the clinical characteristics of these patients was also performed and compared to those with correctly diagnosed melanoma. It was found that 6.5% of all melanomas referred were in fact Spitz naevi and that Spitz naevi represented the majority of pathologically misdiagnosed melanomas. The Spitz naevi were more likely to be on the lower extremities and were no average, considerably smaller than the melanomas. Patients with Spitz naevi were more likely to be younger, female, have fewer dysplastic naevi and have brown eyes. One hundred per cent of the Spitz naevi were brought to the attention of the initial doctor by the patient compared to 72% of the melanomas. This study concludes that Spitz naevi that are pathologically misdiagnosed as melanomas retain the clinical characteristics of other Spitz naevi and that greater clinicopathological communication may reduce the frequency of diagnostic error.