Multiple osteochondromas of the cervical spine, a potential cause of radiculopathy in the elderly: A case report and review of literature

Objective Spinal osteochondromas are rare, and approximately less than 5% occur as spinal lesions. We report the case of a solitary osteochondroma of the spine and review and update the literature on spinal osteochondroma, including surgical treatment and subsequent results. Case Description A 73-year-old female patient complained of a 10-year history of back pain and a 4-year history of right-side lower extremity radiating pain with paresthesia. Computed tomography and magnetic resonance imaging (MRI) revealed a bony mass arising from the inferior articular process (IAP) of L3, presenting with features of compressive spinal stenosis at the L3–L4 level. The treatment strategy included the complete marginal excision of the lesion through the posterior approach, as well as complete decompression of the spinal canal and nerve roots. The patient’s symptoms resolved after surgery, and histopathological examination identified the lesion as an osteochondroma. Review Results This review study included 168 solitary osteochondroma cases. The most commonly involved spinal level was cervical (51.8%), and the most frequent spinal anatomic column involved was the posterior column (70.8%). Radiculopathy accounted for 30.3% of all cases, myelopathy accounted for 31.0%, and 7.7% exhibited both symptoms simultaneously. The recurrence rate was 6.0%. Conclusion Computed tomography and MRI can effectively diagnose spinal osteochondroma, and surgical treatment can effectively improve clinical outcomes. In almost all symptomatic cases, the best treatment is marginal excision of the tumor. Complete resection of the cartilaginous cap of the tumor is especially important to prevent recurrence.

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“…On reviewing the literature, a total of 207 articles were published from 2004 to August 2020, of which 92 articles 4 …”

Section: Discussionmentioning

confidence: 99%

Osteochondroma Arising From the Inferior Articular Process of the Lumbar Spine in a Geriatric Patient: A Case Report and Literature Review

Lin

Chen

et al. 2022

Geriatr Orthop Surg Rehabil

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“…Por lo común se encuentra en el esqueleto apendicular, pero rara vez puede presentarse en el esqueleto axial, incluyendo la columna vertebral, manifestándose en 3% de manera solitaria y de 7 a 9% en su forma de afectación múltiple. 1,2 La localización más frecuente de los osteocondromas es la columna cervical en 50%, afectando principalmente los cuerpos vertebrales de C2, seguido de C3 y C6. La región torácica es la segunda localización en frecuencia con 28% de estas lesiones; se observa mayor incidencia en hombres con una proporción de 1.5:1 con respecto a mujeres.…”

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Osteocondroma espinal; visión general y conceptos básicos

Hinojosa Martínez,

Calderón Varela,

Villalvazo Barón

2023

Cir Columna

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Introducción: los osteocondromas representan 10% del total de las neoplasias óseas y 35% de las lesiones óseas benignas, convirtiéndose así en el tumor óseo benigno más frecuente; sin embargo, se observa baja incidencia de afectación en la columna vertebral, mostrando mayor predilección dentro del esqueleto axial sobre el segmento cervical. El osteocondroma se define como una exostosis osteocartilaginosa con continuidad cortical y medular contigua a la del hueso de origen; la gran mayoría se presenta en su forma solitaria; no obstante, en menor porcentaje, también se puede observar afectación de manera múltiple como parte de un patrón genético autosómico dominante relacionado, en su mayoría, a mutaciones de los genes EXT 1 y 2. Diagnóstico: la presentación clínica dependerá de la localización del osteocondroma, así como de la existencia de algún grado de compresión a la médula espinal, pudiéndose detectar desde una manera incidental hasta la aparición de síntomas neurológicos. Se disponen de múltiples herramientas diagnósticas entre las que tenemos la radiografía, la tomografía axial computarizada, y la resonancia magnética; por lo que se visualiza como una lesión exofítica con continuidad cortical y medular. Sin embargo, el diagnóstico definitivo se realizará por medio del estudio de patología. Tratamiento: dependerá de la presencia o ausencia de sintomatología y se basará en la resección total de la lesión para disminuir el riesgo de recidiva, que podrá acompañarse de técnicas de descompresión en caso de afectación del canal neural.

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Multiple Osteochondromas Comorbid With Enlarged Parietal Foramina, Elongated Styloid Processes, and Tibiofibular Synostosis

Baugher

Batarseh

Becker

et al. 2021

American Journal of Clinical Pathology

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Objectives This study investigates a unique case of multiple osteochondromas (MO) comorbid with enlarged parietal foramina and correlates the findings with the existing literature. The aim of this study is to provide a deeper understanding of anatomic variation for physicians. Methods A 66-year-old White male donor was examined during a routine cadaveric dissection performed by medical students in an anatomy laboratory. Detailed exploration of the skeleton and organs was performed, and photographs were taken. Tissue samples were obtained from multiple outgrowths, and histopathologic examination was done. Results Bilateral bony growths were noted rising from the long bones of the upper and lower extremities (femur, tibia, fibula, and radius). An accessory muscle was found to be associated with the left radial bony growth. Histopathologic examination was positive for osteochondroma. Inspection of the skull revealed enlarged parietal foramina. Other findings included tibiofibular synostosis, abnormally shaped vertebral bodies and ribs, and elongated styloid processes of the skull. Conclusions In combination with the histopathologic examination, the case report and literature review elucidate a more precise clinical picture for those affected with MO or similar disorders. This report also emphasizes the necessity of further investigation of the pathogenesis of MO and Potocki-Shaffer syndrome.

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Multiple osteochondromas of the cervical spine, a potential cause of radiculopathy in the elderly: A case report and review of literature

Cited by 4 publications

References 22 publications

Osteochondroma Arising From the Inferior Articular Process of the Lumbar Spine in a Geriatric Patient: A Case Report and Literature Review

Osteochondroma Arising From the Inferior Articular Process of the Lumbar Spine in a Geriatric Patient: A Case Report and Literature Review

Osteocondroma espinal; visión general y conceptos básicos

Multiple Osteochondromas Comorbid With Enlarged Parietal Foramina, Elongated Styloid Processes, and Tibiofibular Synostosis

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