Seventh cervical vertebral body solitary osteochondroma. Report of a case and review of the literature

Abstract

A 46-year-old female presented with a history of dysphagia due to a lump at the left side of her neck that had been there for a period of almost a year. Pain developed when the neck was turned to the right and it deflected to her left arm, or when local pressure was applied. Examining the lump by palpation, an osseous protuberance, a firmly attached to the cervical spine, was noticed at the base of the neck, over the left anterolateral aspect. Imaging assessment involved anteroposterior and lateral plain radiographs ( Figs. 1 and 2), Computer Tomograpy (CT), (Fig. 3) and Magnetic resonance imaging (MRI) scans of the cervical spine. Whole body bone scintigraphy completed the study.On completion of the patient's clinical and radiological investigation, we were led to believe that her complaints were due to a local tumour in the neck that was firmly attached to the spine at the anterolateral aspect of the C7 and that had the characteristics of a solitary osteochondroma. Abstract Solitary osteochondroma of the cervical spine is a rare manifestation of a common bony tumour. It can create symptoms, depending on the adjacent compressed structures. In this report, a patient suffering solitary osteochondroma on the anterolateral aspect of the C7 vertebral body is presented and the literature is reviewed. A 46-year-old female presented with dysphagia and pain at the anterolateral surface of her neck during cervical movements or application of local pressure. The clinical and imaging assessment ascertained that the above complaints were due to a local tumour in the neck firmly attached to the spine at the anterolateral aspect of the C7 and which resembled an osteochondroma. Surgical treatment was chosen due to the persistence of the symptoms. The lump was resected using an anterolateral cervical approach and it was sent to the pathology department for confirmation of the lesion's histological character. The patient was completely relieved of her symptoms. Resection of the osteochondroma seems to be the only reliable solution for definitive relief from the clinical complaints. This surgical treatment, as it is reported, has no major complications and gives good functional results. One to four per cent of the osteochondromas are located at the spine. At the cervical spine, they can cause neurological symptoms and more rarely, dysphagia. Reviewing the literature, no case of solitary osteochondroma located in the anterior aspect of the C7 body was found. Two cases suffering from dysphagia were reported due to external compression by anterior hyperostosis of the cervical spine, but not due to osteochondroma.

Cervical Spine Osteochondroma: Rare Presentation of a Common Lesion

“…14 Magnetic resonance imaging and noncontrast computed tomography are the examinations of choice especially when prior images cannot rule out malignancy. 4,14 Computed tomography demonstrates the osseous components of the tumor and its relationship to the vertebral and neural elements of the spine 9 but may be poor in the assessment of the cartilaginous component. 10 Magnetic resonance imaging is useful in demonstrating the thickness of the cartilaginous cap, cord compression, and evaluating the relationship of the mass with the adjacent soft tissue.…”

“…2 Only 1% to 4% of cases involve the spine, of which half involve the cervical spine, making cervical spine osteochondroma a rare entity. [3][4][5] Two cases of solitary osteochondroma arising from the anterior aspect of the vertebral bodies of C2 and C7 have been reported 4,6 ; however, none have been reported for C4. We report the first case of solitary osteochondroma arising from the anterior body of C4.…”

Spinal stenosis frequent in children with multiple hereditary exostoses

“…Extra-canal cervical osteochondromas may present with dysphagia, sleep apnea, or a palpable mass [33][34][35][36][37]. Intracanal lesions may cause pain, paresthesias, myelopathy, weakness, or gait disturbance [4,6,[8][9][10]23].…”

Horner Syndrome due to a Solitary Osteochondroma of C7

“…The lesions may stem from any part of a vertebra, including vertebral body, 11,13 pedicle, 6 lamina, 2,12 articular pillar, 7 transverse process, 14 and spinous process, 10 but the most common location is in the posterior elements. Cervical osteochondromas may cause tetraplegia resulting from spinal cord compression, 2,10,11 vertigo, 4 occipital nerve neuralgia, 5 headache, 6 neck and/or shoulder pain, 7,12 hoarseness, 8 cranial nerve palsy, 9 dysphagia, 13 and so forth.…”