Both during and after
cancer treatment, pyogenic
spondylitis is an uncommon but serious complication. Because pyogenic
spondylitis is often recognized as a complication of a distant process causing
bacteremia, it initially may be misdiagnosed the primary
infection such as
urinary tract infection. Consequently, a considerable delay in diagnosis frequently occurs. In addition,
estrogen deprivation caused by
cancer treatments including RT/CCRT, CT and surgical
therapy promotes changes of the immune system. We report two cases of pyogenic
spondylitis in a patient with
vaginal cancer that occurred delay of the diagnosis, and in a patient with
endometrial cancer that had chronic
steroid use, and one case of suppurative
osteomyelitis in a patient with
vulvar cancer that had
diabetes mellitus with
obesity. Gynecologic oncologists must consider the diagnosis of pyogenic
spondylitis based on clinical symptoms such as localized
lumbago and medical history.
Estrogen deprivation, repeated
cancer treatment,
diabetes mellitus with
obesity, immunosuppression by chronic
steroid use are risk factors of pyogenic
spondylitis. To prevent delay in diagnosis of pyogenic
spondylitis, it is necessary that we must have careful management and follow-up considering all of information such as clinical features and medical history on patients during and after treating for gynecologic
malignancies.