Tuberculosis misdiagnosed as brain metastases, consequences be unbearable to contemplate

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(2015-06-20 update) this is a real experience of patients admitted to the clinic.In November 2011, 1 cases of middle-aged women who were dia

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(2015-06-20 update) this is a real experience of patients admitted to the clinic.

In November 2011, 1 cases of middle-aged women who were diagnosed as brain metastases were admitted to the hospital. The data of the patients and the experience of the diagnosis and treatment were summarized.

For the diagnosis and treatment of this patient, I benefited a lot, more firmly regulate the evidence-based principles of cancer treatment (diagnosis and treatment of disease must have sufficient and reliable evidence).

2011-10-17 patients because of headache and dizziness for 2 months to Qingdao a top three hospital, MRI scan showed multiple intracranial brain parenchyma abnormal signal, cerebellar hemisphere, suggestions of strengthening scanning.

2011-10-20 scans were performed with enhanced MRI scans. The results showed that the abnormal signals in the intracranial multiple brain parenchyma could be seen.

2011-11, PET-CT examination showed multiple intracranial abnormalities, mainly in the cerebellar hemisphere, with a slightly higher SUV value of =2.30 in the uterine cavity, and several old calcifications in both lungs.

2011-11-2, in the hospital for the diagnosis of brain metastases from lung cancer. Chemotherapy for lung cancer. Requirements for brain radiotherapy into our hospital.

2011-11-24, after the income of my hospital, that the diagnosis of lung cancer brain metastasis is insufficient evidence, different hospital diagnosis. According to the PET-CT prompt: uterine abnormal signal, our hospital does not agree with the preliminary diagnosis of lung cancer, diagnosed as brain metastasis of choriocarcinoma. After patiently explained, repeatedly asked the patients with curettage examination, finally the patient finally agreed to curettage, scraping pathology: sphacelus. One week after admission, the diagnosis was not clear. Patients with headache and nausea.

Family members of the patient according to the requirements of the hospital's diagnosis as soon as possible to carry out cranial radiation therapy, in the interpretation of the invalid after the signature of a number of families, given the cranial radiation therapy 30Gy/10f, but the patient with poor headache relief.

The 10 time after radiotherapy, second patients with re mobilization curettage results finally found: scraping in tuberculosis with cheese necrosis. The patients were all imaging data and records of the consultation, the final diagnosis was: uterine cavity tuberculosis with intracranial tuberculosis.

2011-12 into the anti tuberculosis anti tuberculosis treatment of six months

2012-05 recovery.

The last follow-up (2015-06-19): the patients were completely recovered, and there was no obvious follow-up reaction after brain radiotherapy.

Reflection: the patient if doctors admissions discomfort after treatment of independent thinking, but according to the diagnosis of a large hospital, the patient will die due to misdiagnosis.

Every doctor should think independently, conscientious, do not let the traces suggest that in order to reduce the misdiagnosis.

 

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