Lumbar solitary osteochondroma presenting with cauda equina syndrome: a case report

Kahveci, Ramazan; Ergüngör, Mehmet Fikret; Günaydin, Ahmet; Temiz, Atiye

doi:10.3944/aott.2012.2599

Cited by 12 publications

(6 citation statements)

References 16 publications

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“…Only 1,3 to 4,1% of solitary osteochondromas involve the axial skeleton. 2 , 14 The incidence of spinal involvement is slightly higher in MHE patients approximately 3%. 17 , 18 50% of spinal osteochondromas arise in the cervical spine with predilection for the posterior arch of C2.…”

Section: Discussionmentioning

confidence: 99%

“…Lesions mostly occur in the posterior arch of the vertebra with the possibility to develop within the spinal canal. They present as radiating leg pain due to nerve root compression, 3 , 4 , 9 , 10 , 12 cauda equina syndrome, 14 foot drop, 13 neurogenic claudication 11 or an atypical spinal curvature. 20 Bess et al estimated that the most common non-neurological presenting symptom for patient with lumbar osteochondroma was a palpable mass (35%) or deformity as reported in our case.…”

Section: Discussionmentioning

confidence: 99%

“…A few cases of lumbar osteochondromas expanding in the spinal canal and presenting with neurological signs have been reported in the literature. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 This is a report of an unusual case of solitary osteochondroma arising from the spinous process of the third lumbar vertebrae.…”

Section: Introductionmentioning

confidence: 97%

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Solitary osteochondroma arising in lumbar spinous process: Case report

Hadhri

Tebourbi

Saidi

et al. 2016

Acta Orthopaedica et Traumatologica Turcica

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Solitary osteochondromas rarely occur in the axial skeleton. Those tumors mostly arise on the posterior elements of the cervical column causing various symptoms especially when developing within the spinal canal. Exophytic lumbar variety is uncommon presenting with palpable mass or spinal deformity. We report a 20-year-old man presenting with a solid painless mass at the lower lumbar region. Radiological examinations revealed an exophytic lesion arising in the third lumbar spinous process appearing to be a solitary osteochondroma. The lesion was treated by en-bloc resection; histopathological examination confirmed the diagnosis of osteochondroma with no evidence of recurrence at the end of 2-year follow up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Solitary osteochondroma arising in lumbar spinous process: Case report

Hadhri

Tebourbi

Saidi

et al. 2016

Acta Orthopaedica et Traumatologica Turcica

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“…Embora no exame de imagem do paciente houvesse alterações degenerativas entre L7-S1, é importante lembrar que este achado é comum nos exames de imagem de cães idosos de grande porte [1]. A avaliação dos sinais clínicos sugeriu síndrome da cauda equina por ELD [15], mas os aspectos que reforçaram a suspeita de que a estrutura calcificada visibilizada na TC [12] fosse responsável pelo quadro clínico foram a presença de dor mais acentuada na palpação da vértebra L6, o quadro clínico progressivo, o fato do animal manter os membros pélvicos flexionados, principalmente o esquerdo, indicando sinal de raiz [2,3] e a idade avançada do paciente. Há uma descrição de quadro clínico semelhante em um cão com um lipoma perirradicular fusiforme no interior do canal da vértebra L6 [21].…”

Section: Discussionunclassified

“…uma capa cartilaginosa, que se elevam na superfície externa das escápulas, costelas, vertebras e pelve de cães jovens apresentando continuidade com o osso do qual se originaram [2,6,8,10], o mesmo ocorrendo em humanos, equinos, cães e gatos jovens com osteocondroma solitário da coluna [11,17]. Ocasionalmente a massa, originada do tecido ósseo da vértebra, cresce em direção ao interior do canal vertebral, comprimindo o tecido nervoso [11,12], mas isso não foi observado no presente relato.…”

Section: Discussionunclassified

Excisão cirúrgica de um osteocondroma de raiz nervosa da cauda equina de cão

Barros¹,

Valentim²,

Dias³

et al. 2018

Acta Scientiae. Vet.

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Background: Spinal neoplasms are classified into extradural, intradural/extramedullary or intramedullary. Intradural/extramedullary tumors include meningiomas and nerve sheath tumors, which arise from meninges or peripheral nerves around the spinal cord. Clinical signs are related to dysfunction of the involved nerve and include pain, nerve root signature and atrophy. Osteochondromas are benign tumors located within the bone, on its surface or in extra-osseous regions, when they are classified as soft tissue osteochondoma. The aim of this study is to describe a case of an osteochondroma in a nervous root of the cauda equina in a dog, whose surgical resection allowed the resolution of the clinical signs.Case: A 12-year-old, male, Labrador Retriever dog, was presented with a 40-day history of progressive, painful, pelvic limb paresis, with no improvement when treated with analgesics and acupuncture. Neurological abnormalities included paraparesis, sometimes worse in the left pelvic limb, that was carried flexed at the level of the stifle, hindlimb atrophy, decreased interdigital reflexes and pain in the lumbar spinal region, mainly over L6 vertebra. Results of blood count and serum biochemical analysis were unremarkable. Computed tomography (CT) of the lumbosacral area was performed and the evaluation of images in transverse and reconstructed dorsal and sagittal planes allowed the visualization of a hyperattenuating and calcified round structure with 8 mm x 6 mm, in the left side of vertebral canal, at the level of caudal epiphysis of L6. Lumbosacral (L7-S1) CT abnormalities, as subchondral sclerosis, mild disc margin bulging, spondylosis deformans and foraminal proliferation were also observed but were considered clinically insignificant. Then, a dorsal L6 laminectomy was performed and after opening of the vertebral canal it was observed the presence of an ovoid mass, in the left side of the medullary cone, measuring approximately 0.9 cm in length, originating from a sacral nerve root. This structure was excised and submitted to histopathological evaluation. The dog improved after surgery without any complications, and neurological functions were gradually recovered. The histopathology of the mass was confirmed as an osteochondroma.Discussion: The history and neurologic examination findings as well the improvement after surgery were compatible with the lesion visualized by TC in L6, rather than the degenerative changes in L7-S1. Regarding the position of the mass, the main differential would be nerve sheath tumor, one of the most common types of primary neoplasia of the peripheral nervous system, however in a CT study in dogs with brachial plexus and nerve roots neoplasms, calcification of the tumor was not observed. Most of benign cartilaginous tumors of soft tissue are chondromas/osteochondromas, and this lesion should not be confused with multiple osteochondroma or multiple cartilaginous exostoses, which have been reported as multifocal, proliferative lesions involving the surface of ribs, vertebrae and pelvis of young dogs. If this lesion is unique, it is called osteochondroma. There are two reports of chondromas into the first lumbar vertebrae of dogs, with adherence to the floor of the vertebral canal and one report of an osteochondroma originated from the left pedicle of T11 in a cat. Radiculopathy and myelopathy caused by osteochondromas inside the spine are rare in humans and description of this tumor arising from nerve roots were not found in the veterinary literature. Probably the origin of the mass was metaplasia of the meninges surrounding the nervous root. In conclusion, neurological examination, CT and surgical exploration allowed the diagnosis and removal of a soft tissue osteochondroma, a rare benign tumor, with good patient recovery.

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