Unusual case of hereditary multiple exostoses presenting with compressive myelopathy

Abstract

A 15-year-old boy presented with progressive weakness of both lower limbs. He had classical clinical features suggestive of multiple hereditary exostoses (MHE). Imaging studies of the spine revealed osteochondromas at D7, D11 and L5 vertebrae. The tumour at D11 was encroaching into the spinal canal and causing cord compression. The patient underwent osteochondroma excision and posterior spinal stabilisation, following which there was complete neurological recovery by 3 months.

An unusual example of hereditary multiple exostoses: a case report and review of the literature

“…Lesions of the vertebral column are more common in the superior spine; 30-80% of the lesions have been reported in the cervical spine, 20-30% in the thoracic spine and only a few reports have cases in the lumbar region [29]. Specially C2 is the most common vertebra to have a tumour followed by C3 and C6 [27].…”

“…Specially C2 is the most common vertebra to have a tumour followed by C3 and C6 [27]. Jackson et al [28] reported that the average lesions in a single patient was 2.25 with the range being between 1 and 4, in addition it has been stated that finding lesions in multiple levels of the vertebral column is rare [29]. The osteochondromas that do grow on the vertebrae can occur in multiple areas reflecting the many ossifications centres; they are found on the vertebral bodies, tips of the spinous processes, the transverse processes and the articular processes [5].…”