Retro-odontoid pseudotumor: a poorly recognized alteration of the craniocervical junction

Abstract

<jats:p>SUMMARY INTRODUCTION Retro-odontoid pseudotumor (ROP) is a rare disease that affects the atlantoaxial joint and, in general, is associated with local biomechanical alterations that may or may not cause instability. METHODS Descriptive study of the literature available in databases MEDLINE/PubMed, LILACS, and Scopus. The research was conducted in April 2019. DISCUSSION ROP is, possibly, a syndromic designation that encompasses a significant variety of diseases of the atlantoaxial joint. There are different pathophysiological mechanisms implicated in its genesis. The patients, almost in their entirety, present with severe myelopathy, and most of them are treated surgically, with the posterior decompression being the most commonly used method, with or without arthrodesis. Evolution is usually favorable. CONCLUSION The ROP is still poorly recognized as a differential diagnosis between the diseases of the cranial-cervical junction. The information available in the literature analyzed was based mainly on the study of reports or case series; therefore, it is insufficient to define conducts with a high level of scientific evidence.</jats:p>

Periodontoid pseudotumoral lesions

“…ROP tumor is most often attributed to rheumatoid arthritis,[ 11 ] cervical spondyloarthropathy,[ 5 ] primary amyloidosis, and hemodialysis. [ 2 ] Tanaka et al . [ 13 ] classified these lesions into three types, those with: (1) atlantoaxial subluxation, (2) subaxial spondylosis, or (3) secondary to herniation of an intervertebral disc.…”

Retro-Odontoid Pseudotumor due to Rheumatoid Arthritis Pannus and its Craniocervical Instability

“…The differential diagnosis includes meningioma and chordoma; hence, biopsy is indicated in cases of suspicion. This study aims to demonstrate an effective therapeutic alternative through the presentation of a clinical case and a relevant literature review, allowing for immediate medullary decompression, resolution of the etiological instability underlying the described pathology, and obtaining material for histopathological analysis and definitive diagnosis [1][2][3][4].…”