Chondroma of the Thoracic Vertebrae Base with Abdominothoracic Aorta Involvement, a Case Report and Review of the Literature

Abstract

Spinal chondroma is a rare benign tumor it accounts for 2.8% of benign bone tumours and 12% of all bone tumours. 3.6% to 4% of chondroma are located in the spine representing 10% of all chondromas. It can originate from the vertebral bodies or the posterior arch and is described in patients between 5 and 78 years of age [1]. We present the clinical case of a 60 year old woman, who consulted for dorso-thoracic pain around the belt line and who was treated as a gastroduodenal ulcer, after a Pott's disease on the basis of an imaging diagnosis showing spondylodiscitis lesions with a paravertebral spindle D11-D12. Firstly, it was operated by a posterior approach by laminectomy spondylodesis of D10 D11- L1 L2 and biopsy of the tumor whose anatomopathological examination diagnosed a vertebral chondroma directing towards a total corporectomy by anterior or antero-lateral way. After the refusal of the second operation by the patient, she came back in consultation 3 months later with Frankel B paraplegia, anemia and cachexia. The MRI and CT show the evolution of the spondylolytic tumor D10 D11 with debricolage of the osteosynthetic material and invasion of the thoracic aorta with its collaterals; the very high risk of damaging the Adam kiewizc artery and of postoperative paraplegia during the anterior management without endovascular material by the thoracic team compromised this second operative step. The low sensitivity of chemotherapy and the risk of aggravation of the lesion by the therapeutic doses of radiotherapy for this tumour was directed in palliative care.
 Dorsal vertebral chondroma is a rare benign tumour that requires early complete resection to avoid the risk of thoracic aortic inversion that can increase complications and compromise the definitive treatment of this benign tumour.