Background: Osteochondroma is a common benign tumor arising from the long bones. It rarely arises in the spine, where it can cause mild symptoms such as backache all the way up to compressive myelopathy. Malignant transformation has also been reported. Here, the authors present a 52-year-old male with myelopathy attributed to a rare thoracic solitary osteochondroma. Case Description: A 52-year-old male presented back pain radiating into both lower extremities with paresthesia to the toes of 1 year’s duration. On examination, he exhibited hyperactive bilateral lower extremity reflexes with bilateral Babinski signs, and focal sensory changes to pin, and touch appreciation in the left L5S1 distributions. Computed tomography and magnetic resonance imaging showed an abnormal bony mass arising from the posterior arch of T10 with protrusion into the spinal canal resulting in marked canal/cord compression. Surgery included a D10 laminectomy with en bloc resection of the lesion. Postoperatively, the patient’s symptoms resolved. Histologically, the lesion was an osteochondroma. Conclusion: When patients present with myelopathy, one should include osteochondromas among the differential diagnostic possibilities.

Background: Spinal teratomas are rare in adults. The clinical findings are nonspecific, reflecting only in the intramedullary location of these lesions. The potential differential diagnosis for intramedullary spinal teratomas include schwannomas, dermoids, epidermoids, and neurofibromas. Case Description: A 25-year-old male presented with RLE weakness (iliopsoas/quadriceps [4/5], and extensor hallucis longus/dorsiflexor [0/5]) and urinary incontinence. As the contrast, MR showed a heterogeneous intramedullary lesion with well-defined edges located at the T12-L1 level, the patient underwent a focal laminectomy for gross total tumor excision. Pathologically, it proved to be a mature teratoma. Conclusion: Teratomas should be considered among the differential diagnostic considerations for intramedullary spinal cord lesions. Although gross total resection is preferred, these lesions have a low recurrence rate, and therefore, partial removal is also valid, where lesions are densely adherent to adjacent neural structures.

Spontaneous spinal extradural hematomas are rarely attributed to hemophilia. When it occurs, magnetic resonance imaging (MRI) best establishes the diagnosis that should prompt immediate medical or surgical management. Here, we present a case with large spinal epidural hematomas (EDH) which was managed conservatively with good neurological outcome. A 12-year-old male who is a known case of hemophilia A was admitted with a complaint of neck pain, was neurologically intact on examination with no motor or sensory deficits. MRI cervical spine revealed a large spinal EDH in the cervical region compressing the cord posteriorly. The patient was managed conservatively with tranexamic acid and factor VIII replacement and observed over few days. He recovered well with interval resolution of hematoma. this case depicts the role of conservative management of spontaneous EDH in patients with Hemophilia A utilizing factor replacement therapy, steroids, and tranexamic acid and emphasizes that surgery is not always required even in such radiologically large appearing lesions.

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