Erdheim-Chester disease in thoracic spine: a rare case of compression fracture

Abstract

A55-year-old man with back pain for about 2 months was admitted to an orthopedics department. A plain radiological examination of the thoracic spine revealed a collapse of the T2 vertebra. Preoperative magnetic resonance imaging and a computed tomography scan showed a collapse of the T2 vertebra body (Figs. 1 and 2). The lesion involving theT2 vertebra body showed heterogenous enhancement inT1-weightedmagnetic resonance images after administration of gadolinium (Fig. 2). An open bone biopsy of the T2 vertebra body was performed. Based on the histopathologic and radiological findings, the patient was diagnosed with Erdheim-Chester disease (ECD) with involvement of bone marrow (Fig. 3). Erdheim-Chester disease is an infrequent, non-Langerhans cell histiocytosis of unknown etiology that typically affects the lower extremity of long bones, causing osteosclerosis. Isolated axial skeleton involvement of ECD is extremely rare. Imaging features of ECD involvement of vertebra are not specific, so pathologic confirmation is needed. As in our case, the possibility of ECD in patients with compression fracture can be considered [1,2]. References