Cervical Osteochondroma Presenting as Brown-Sequard Syndrome in a Child with Hereditary Multiple Exostosis

Han, Inho; Kuh, Sung Uk

doi:10.3340/jkns.2009.45.5.309

Cited by 18 publications

(16 citation statements)

References 9 publications

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“…31 The majority of osteochondromas are found in long bones and the appendicular skeleton; however, they can be found in any bone formed through endochondral ossification. 1 Many complications can occur from solitary and multiple osteochondromas. In this case, the patient exhibited slight bowing of the right lower extremity and range-of-motion limitations with forearm supination secondary to mass effect.…”

Section: Discussionmentioning

confidence: 99%

“…Many osteochondromas are asymptomatic; however, complications can involve bone, nerve, and soft tissues via mass effect or intrinsic change [1][2][3][4][5][6][7][8][9][10] (Fig 1).…”

Section: Introductionmentioning

confidence: 99%

“…Sixty-five percent of these tumors are located around the knee and proximal humerus and 20% arise in the axial skeleton, and of these, approximately 5% occur in the vertebral column. 1,[14][15][16] Solitary osteochondromas develop in isolated bones and are not hereditary, whereas multiple osteochondromas can occur spontaneously or as part of an autosomal dominant disorder known as hereditary multiple exostosis (HME). 10 Both genders can be affected equally, but there is a slight male predominance.…”

Section: Introductionmentioning

confidence: 99%

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Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Zoboski

2017

Journal of Chiropractic Medicine

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Objective: The purpose of this report was to describe the presentation of a patient with hereditary multiple exostoses and thoracic spinal cord compression from an osteochondroma. Clinical Features: A 31-year-old female presented to a chiropractic clinic with a history of hereditary multiple exostoses and back pain that had existed since the age of 16 years. She had a past medical history that was remarkable for 3 prior surgeries for mass removal. Examination revealed a left upper midscapular mass with decreased sensation. Intervention/Outcome: Magnetic resonance imaging, computed tomography, and biopsy led to a diagnosis of osteochondroma. These diagnostic modalities confirmed that there was no malignant degeneration. Initial magnetic resonance imaging revealed a large expansive lesion involving the left posterior elements at the region of T3-T4. Subsequent thoracic hemilaminectomy and resection of the spinal tumor with posterior instrumentation and stabilization from T2-T5 resulted in 90% overall subjective improvement. Conclusions: A detailed case history, thorough examination, guided advanced imaging, and biopsy provide important information for the diagnosis and appropriate treatment of expansive lesions in patients with hereditary multiple exostoses. (J Chiropr Med 2017;16:72-77)

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Section: Discussionmentioning

confidence: 99%

“…Many osteochondromas are asymptomatic; however, complications can involve bone, nerve, and soft tissues via mass effect or intrinsic change [1][2][3][4][5][6][7][8][9][10] (Fig 1).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Zoboski

2017

Journal of Chiropractic Medicine

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“…Han and Kuh5 reported BSS due to posterior cord compression caused by an osteochondroma arising from the C7 lamina in a known case of HME. The pure BSS reflecting hemisection of the cord is not often observed.…”

Section: Discussionmentioning

confidence: 99%

“…In this report, we discuss a rare case of a solitary osteochondroma of D2–D3 vertebrae presenting as Brown-Séquard syndrome (BSS). Osteochondromas rarely cause BSS 5. The possible pathophysiology, clinical course and treatment outcome have been discussed.…”

Section: Introductionmentioning

confidence: 99%

Solitary thoracic osteochondroma presenting as Brown-Séquard syndrome

Ramdasi

Mahore

2014

BMJ Case Reports

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SUMMARYWe discuss a rare case of solitary osteochondroma arising from D2-D3 vertebrae presenting as Brown-Séquard syndrome (BSS) in a 28-year-old man following a fall. MRI revealed cord compression by an extradural ventrolateral tumour projecting into the spinal canal at D2-D3 level. Intraoperatively, it was found to be a bony tumour arising from the left of the D2 and D3 vertebral bodies, left pedicles and adjacent articular facets. The neurological deficits of the patient improved after the surgery. BACKGROUND

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Spinal stenosis frequent in children with multiple hereditary exostoses

Ashraf

Larson

Ferski

et al. 2013

Journal of Children's Orthopaedics

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Purpose Children with multiple hereditary exostoses (MHE) have numerous osteochondromas, with the most prominent lesions typically over the appendicular skeleton. A recent report noted a high rate of intracanal lesions in this patient population and recommended preventative spinal screening with magnetic resonance imaging (MRI) or computed tomography (CT). We sought to evaluate the prevalence of spinal stenosis from intracanal osteochondromas at our pediatric orthopedic center in order to evaluate if routine screening is warranted. Methods All pediatric patients treated for MHE were retrospectively identified. Records were reviewed to determine demographics, previous orthopedic surgery, and indication and results of axial spine imaging (CT or MRI).Imaging studies were reviewed to evaluate the presence of intracanal and compressive spinal lesions. Results Between 1990 and 2011, axial imaging was performed in nine patients with MHE due to concerns of pain, weakness, and/or dizziness. These patients had moderate disease involvement, with a mean of 4.9 previous orthopedic surgeries to address skeletal osteochondromas. Two patients with MHE had cervical spinal stenosis secondary to intracanal osteochondromas. Both children successfully underwent spinal decompression. Thus, of our MHE population undergoing axial imaging, 22 % were noted to have intracanal lesions. Conclusions Our experience reveals a [20 % rate of compressive intracanal osteochondromas in MHE patients undergoing spinal imaging. These two patients represent 5 % of the MHE patients treated at our center. These lesions may be slow growing, and significant consequences can occur if not identified promptly. Thus, we confer that routine axial screening of the spinal canal may be warranted in these children.

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Cervical Osteochondroma Presenting as Brown-Sequard Syndrome in a Child with Hereditary Multiple Exostosis

Cited by 18 publications

References 9 publications

Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Osteochondroma and Spinal Cord Compression in a Patient With Hereditary Multiple Exostoses: A Case Report

Solitary thoracic osteochondroma presenting as Brown-Séquard syndrome

Spinal stenosis frequent in children with multiple hereditary exostoses

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