Intraspinal dural‐based primary osteoblastoma with aneurysmal bone cyst‐like change

Abstract

Osteoblastoma is a benign bone-forming neoplasm that occurs commonly in the posterior elements of the spine and the sacrum. However, so far there has been no report of intradural osteoblastoma described in the literature. We present a unique case of intraspinal dural-based osteoblastoma with aneurysmal bone cyst-like change without evidence of vertebral involvement. An 11-year-old Chinese girl presented with a 3-month history of gradually progressive back pain and a weakness of both lower limbs. Thoracic MRI revealed a well-demarcated subdural mass at the T5 level with heterogeneous enhancement. Histologically, the tumor was found to be attached to the dura and composed of numerous osteoid spicules and trabecular bone with diffusely scattered osteoclast-type, multinucleated giant cells. Ectactic blood vessels and blood-filled cystic spaces were also observed. A diagnosis of primary intraspinal dural-based osteoblastoma with aneurysmal bone cyst-like change was made. To our best knowledge, this is possibly the first case of primary osteoblastoma arising from meninges. Meningeal osteocartilaginous tumors are rare, with obscure histogenesis. The differential diagnosis of osteoblastoma in unusual locations is difficult and the confirmation of diagnosis should be cautiously made. Awareness of dural-based osteoblastoma and its histological features is important to avoid a diagnostic pitfall caused by histological similarities to other intra-craniospinal lesions with osteoid differentiation or bone formation.

Osteoblastomas of the spine: a comprehensive review

“…Components of aneurysmal bone cysts are reported to be present in approximately 10%-15% of cases of osteoblastomas. 34,40,60,70,73,93 This finding may confound the final pathology findings. Osteoid osteoma transitioning to an osteoblastoma has been reported in the literature, although this not a common occurrence.…”

Surgical Excision of Thoracic Osteoblastoma with Secondary Aneurysmal Bone Cyst from a 12-Year-Old Child

“…Some report that those diagnosed with aggressive osteoblastoma may have a recurrence rate of 50 percent. To our knowledge, there are only a few reports of osteoblastoma with secondary aneurysmal bone cyst in the paediatric thoracic spine [2,3] and few others in the cervical spine [4,5].…”

“…They represent 1 percent of all bone tumours and about two-fifths of them are localized to the Pediatr Neurosurg 2020;55:280-288 DOI: 10.1159/000510015 spine [1]. More aggressive osteoblastoma may present with features of aneurysmal bone cyst and to our best knowledge, there are only a few reports of these in the paediatric thoracic spine [2,3] and few others in the cervical spine [4,5]. We report the case of a 12-year-old child having an osteoblastoma on the left side of T11 with secondary aneurysmal bone cyst presenting with neurological deficits and myelopathic symptoms who underwent surgical excision with good results.…”