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Musculoskeletal Misdiagnoses in Pediatric Patients with Spinal Tumors
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  • Aurora Dybedokken,
  • René Mathiasen,
  • Henrik Hasle,
  • Troels Herlin,
  • Michael Thude Callesen,
  • Søren Holm Hansen,
  • Laura Hallundbæk Jensen,
  • Jesper Amstrup,
  • Søren Hagstroem,
  • Ninna Brix
Aurora Dybedokken
Aalborg Universitetshospital
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René Mathiasen
Rigshospitalet
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Henrik Hasle
Aarhus Universitetshospital
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Troels Herlin
Aarhus Universitetshospital
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Michael Thude Callesen
Odense Universitetshospital
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Søren Holm Hansen
Odense Universitetshospital
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Laura Hallundbæk Jensen
Aalborg Universitetshospital
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Jesper Amstrup
Aalborg Universitetshospital
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Søren Hagstroem
Aalborg Universitetshospital
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Ninna Brix
Aalborg Universitetshospital

Corresponding Author:[email protected]

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Abstract

Objective: Childhood spinal tumors often present with musculoskeletal symptoms, potentially causing a misdiagnosis and delays in diagnosis and treatment. This study aims to identify, characterize, and compare children with spinal tumors who had prior musculoskeletal misdiagnoses to those without, analyzing clinical presentation, diagnostic interval, and outcome. Study design: This retrospective cohort study evaluated all children aged 0-14 years diagnosed with a spinal tumor in Denmark from 1996 to 2018. The cohort was identified through the Danish Childhood Cancer Registry, and the registry data were supplemented with data from medical records. The survival was compared using the Kaplan-Meier method. Results: Among 58 patients, 57% (33/58) recieved musculoskeletal misdiagnoses before the spinal tumor diagnosis. Misdiagnoses were mostly non-specific (64%, 21/33), involving pain and accidental lesions, while 36% (12/33) were rheumatic diagnoses. The patients with prior misdiagnosis had less aggressive tumors, fewer neurological/general symptoms, and 5.5 months median diagnostic interval versus 3 months for those without a misdiagnosis. Those with prior misdiagnoses tended to have a higher 5-year survival of 83% (95% CI 63-92%) compared to 66% (95% CI 44-82%) for those without (p=0.15) Conclusion: Less aggressive spinal tumors may manifest as gradual skeletal abnormalities and musculoskeletal symptoms without neurological/general symptoms, leading to misdiagnoses and delays.
30 Oct 2023Submission Checks Completed
30 Oct 2023Assigned to Editor
30 Oct 2023Submitted to Pediatric Blood & Cancer
02 Nov 2023Review(s) Completed, Editorial Evaluation Pending
13 Nov 2023Reviewer(s) Assigned
17 Mar 2024Submission Checks Completed
17 Mar 2024Assigned to Editor
17 Mar 20241st Revision Received
03 Apr 2024Review(s) Completed, Editorial Evaluation Pending