Osteoblastoma of the thoracic spine presenting with back pain

Abstract

A 22-year-old man presented with complaint of persistent back pain. His medical history and physical examination were unremarkable. Magnetic resonance imaging (MRI) revealed an expansile, circumscribed lesion (2×1.5×1.3 cm) located in the right inferior articular process and pedicle of the 10th thoracic vertebra (Fig. 1). It extended anteroinferiorly into the right neural foramen and lateral recess, causing compression of the spinal nerve at the T10–T11 levels (Fig. 2). It was mildly hypointense to muscles on T1-and T2weighted images. Surrounding intense soft tissue and bone marrow edema was also seen. The lesion was isodense to bone, without adjacent cortical erosion or sclerosis on computed tomography images. Enhancement of the lesion and the adjacent reactive edema were seen on post-contrast MRIs. Imaging findings were compatible with osteoblastoma. Surgical resection of the tumor was performed, and histologic examination revealed the diagnosis of osteoblastoma. No neurologic deficits were observed after surgery. Followup MRI at 3 months showed postoperative changes, but no residual tumor. There has been a significant reduction in the patient’s back pain. Osteoblastoma is a rare, benign primary bone tumor that is mostly located in the spine (40%), especially the posterior elements. Surrounding reactive bone marrow and soft tissue edema and enhancement can be seen [1].