PERIPROSTHETIC METASTATIC CARCINOMA - PITFALLS IN THE MANAGEMENT OF 2CASES INITIALLY DIAGNOSED AS OSTEOLYSIS

Periprosthetic osteolysis is a well-described phenomenon associated wi th total hip arthroplasty. Two cases are presented in which apparently healthy patients developed lytic lesions adjacent to cementless hip i mplants. Despite atypical features, the lesions were initially attribu ted to wear debris-induced osteolysis, and it was discovered during re vision surgery that metastatic tumor was present. For one patient, if the initial diagnosis had been correct, subsequent surgery and related complications may have been avoided. II is important to consider the entire differential of radiolucent bone lesions whenever a patient pre sents with periprosthetic osteolysis. If revision surgery is not warra nted on the basis of loosening, then a thorough medical examination, c lose follow-up evaluation, and/or biopsy should be performed to rule o ut metastatic disease.