Fifth lumbar vertebrae solitary osteochondroma arising from the neural arch, a case report

Mohamed Abdel Zaher,Mohammad Ali Alzohiry,Omar Refai,Ahmed A Khalifa,Amr A Fadle

doi:10.1186/s41984-021-00127-9

Mohamed Abdel Zaher, Mohammad Ali Alzohiry + Show 3 more

Open Access

https://doi.org/10.1186/s41984-021-00127-9

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Abstract

BackgroundOsteochondromas are a benign outgrowth of bone and cartilage and one of the most common bone tumors that usually occur in long bones, with only 1–4% being located in the spine, more frequently in the cervical and upper dorsal region, and rarely the lumbar spine. Here, we report a case of lumbar spine (L5) osteochondroma arising from the neural arch.Case presentationA 30-year-old man presenting with a solid painless mass at the lower lumbar region. No neurological symptoms. Radiological examinations revealed an exophytic lesion in the fifth lumbar articular process, and the spinous process appears to be a solitary osteochondroma. Lumbar spine magnetic resonance imaging showed a bony lesion covered by a 2-mm-thick cartilaginous cap. Surgical en bloc resection of the mass was performed, and the histopathological examination confirmed the diagnosis of osteochondroma. No evidence of recurrence at the end of 4-year follow-up.ConclusionOsteochondromas are benign tumors rarely present in the spine; diagnosis can be made by the typical appearance of the cartilaginous cap over the mass in the magnetic resonance imaging. Surgical excision is the best management option.

Highlights

Osteochondromas are a benign outgrowth of bone and cartilage and one of the most common bone tumors that usually occur in long bones, with only 1–4% being located in the spine, more frequently in the cervical and upper dorsal region, and rarely the lumbar spine
Osteochondromas are benign tumors rarely present in the spine; diagnosis can be made by the typical appearance of the cartilaginous cap over the mass in the magnetic resonance imaging
This case report describes an unusual presentation of a solitary osteochondroma arising from the neural arch of the posterior element of the fifth lumbar vertebrae in a male patient

Summary

Conclusion

We presented a rare case of lumbar spine osteochondroma originating from the posterior element of L5; besides clinical and neurological assessment, a spine CT and MRI are paramount for diagnosis. Surgical excision is the management of choice, especially if the patient developed neurological symptoms.

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