Level of Evidence IV, Case Series.įratura patológica é um evento esquelético frequente em pacientes com câncer de pulmão, resultando em alta morbidade e sobrevida global reduzida que torna a decisão de tratamento cirúrgico desafiadora. Pathological fracture was associated with synchronous bone metastases and overall survival times were considerably reduced. The median overall survival following the diagnosis of lung cancer, bone metastases, and pathological fracture was 6, 4, and 2 months, respectively. Pathological fractures were more frequent among patients with bone metastases at the time of diagnosis of lung cancer (24.7% vs. The prevalence of bone metastases and pathological fractures was 28.2% (n = 115) and 19.1% (n = 22), respectively. Overall survival was determined using the Kaplan-Meier method and differences were compared using the log-rank test. Statistical analysis was conducted using a chi-squared test, and the odds ratio and 95% confidence interval were calculated. The prevalence of bone metastases and pathological fractures was calculated. We conducted a retrospective cohort study with 407 lung carcinoma patients diagnosed between 20. To identify risk factors associated with the occurrence of pathological fractures in patients with lung cancer and to determine survival. Scoring systems have been developed to assess the fracture risk of bone metastases, the Mirels classification is the one that has gained the most traction, although its poor sensitivity (35%) means that it is not without its controversy 5.Pathological fractures are frequent skeletal-related events among lung cancer patients, which result in high morbidity and decreased overall survival and make operative treatment decisions challenging. In principle, every osteolytic focus in the femoral neck or the spine is at risk of a pathological fracture. Practical pointsĪ radiologist should mention the possibility of a pathological fracture if an osteolytic metastasis is seen. Pathological fractures are feared by oncologists because they may cause immobilization of their patients, especially when the spine or lower extremities are affected. Well-defined, homogenous T1-hypointense abnormal signal without normal intervening marrow signalĭiffuse uptake of radiopharmaceutical by the lesion 4 Radiographic features Radiography and CTĭestruction or focal defect within the inner layer of bony cortex In addition, in adult patients, the avulsion of the femoral lesser trochanter should be considered a pathological fracture until proven otherwise 4. ![]() The most common location for pathological fractures are 4: Fragility fractures on the other hand, are acute fractures in osteoporotic patients due to a single event of minimal trauma. Insufficiency fractures are fractures due to multiple minor events causing a cumulative load on weakened osteoporotic bone. Paget disease, osteopetrosis), although the term insufficiency fracture is probably more correct 4. It can be used in the setting of generalized metabolic bone disease (e.g. The term pathological fracture is usually reserved for tumors, either benign or malignant, although it has been used in the setting of osteomyelitis.
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