Large enchondroma of the thoracic spine: a rare case report and review of the literature

Jing Guo,Ju-Zhou Gao,Er-Xing He,Lian-Jin Guo,Zhi-Xun Yin

doi:10.1186/s12891-017-1519-z

Abstract

BackgroundEnchondroma, a subtype of chondroma, originates from the medullary cavity of the bone and produces an expansile growth pattern. Enchondroma located in the spine is rare and a few cases of large thoracic enchondroma have been reported. The authors document a rare case of large enchondroma in the thoracic spine of a 49-year-old woman, and discuss its clinical, radiological and histopathological characteristics.Case presentationThe patient presented with rapidly progressive and severe pain on her upper back. Magnetic resonance imaging revealed an expansile lesion at the posterior elements of T3 that was hypointense on T1-weighted images and mixed iso- to hyperintense on T2-weighted images. Administration of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) resulted in heterogeneous enhancement. During surgery, a large tumor of 4.2cm × 4.7cm × 2.1cm was resected along with the lamina and spinous process. Histological examination revealed that the tumor consisted of mature hyaline cartilage with typical chondrocytes, indicating that it was an enchondroma.ConclusionsDespite its benign-growing nature, enchondroma should be examined closely for signs of enchondromatosis and enchondrosarcoma. Complete surgical resection is the treatment of choice for immediate relief of symptoms and avoidance of recurrence.

Highlights

BackgroundChondroma is a slowly growing benign cartilaginous tumor, and rarely affects the spine [1]
Enchondroma, a subtype of chondroma, originates from the medullary cavity of the bone and produces an expansile growth pattern
Complete surgical resection is the treatment of choice for immediate relief of symptoms and avoidance of recurrence

Summary

Background

Chondroma is a slowly growing benign cartilaginous tumor, and rarely affects the spine [1]. Periosteal chondroma arises from the surface of periosteum and grows in an exophytic fashion [2]; whereas, enchondroma originates from the medullary cavity and produces an expansile growth pattern [3, 4]. To the best of our knowledge, few report on large enchondroma in the thoracic spine exists in literatures. We report on a 49-year-old woman with severe upper back pain due to a large enchondroma at the posterior elements of T3 vertebra. Case presentation A 49-year-old woman presented with progressive and severe upper back pain for 1 month. Plain radiographs of the thoracic spine showed a radiolucent lesion at the T3 spinous process (Fig. 1). Computed tomography (CT) revealed an expansile lesion of osteolysis at the posterior elements of T3, involving spinous process, lamina, right-side transverse process and pedicle (Fig. 2). The right transverse process was removed, followed by curettage of the pedicle to

Discussion

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Conclusion