“Occult” Roentgenographic Osteoblastoma of the Cervical Spine

Abstract

A 33-yr-old man presented with a 4-yr history of neck pain. Previous work-ups, including planar radiographs and magnetic resonance imaging, were determined as "normal" by six previous consultants. In a subsequent in-office evaluation by a physiatrist, a vertebral osteoid osteoma or carotid artery angiitis was clinically suspected. A bone scan of the cervical spine was consistent with a the presence of an of osteoid osteoma. Thereafter, repeat magnetic resonance imaging confused the issue by suggesting the presence osteomyelitis involving the C3-C4 facet joint. Spiral cervical spine computed tomography with digital reconstruction once again demonstrated the presence of an osteoblastoma. The patient was subsequently referred to a spinal surgeon for biopsy and resection, which confirmed the presence of an osteoblastoma. Although benign cervical neoplasms presenting as neck pain occur most often in a pediatric population, at any age, the differential diagnosis of intractable neck pain should include the possibility of a primary osseous or metastatic tumor.

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

“…Plain radiography is the most common radiological choice and is thought to have great value for diagnosing spinal OBLs [17][18][19][20]. However in our study, normal images were found in half of the patients with CO and onefourth of cases with AO, which might cause a high number of misdiagnoses if it were the only diagnostic tool used.…”

Osteoblastoma of the Third Cervical Vertebra in a 16-Year-Old Boy: Case Report and Review of the Literature

“…The typical plain radiographic feature of the lesion is a lytic and expansile lesion [1,7,8,17,20], as in our case (fig. 1).…”

“…This lesion occurs 4 times less often than osteoid osteoma and is 20 times less frequent than osteosarcoma [1,3,4,8,9,17,20]. Benign osteoblastoma was independently described in 1956 by both Jaffe [14] and Lichtenstein [21].…”

Imaging of the Lumbar Spine Neoplasms

“…On MRI, they commonly exhibit edema of the surrounding marrow and soft tissues. 43,47,48 Osteosarcoma Osteosarcoma is the most common nonhematological primary malignancy of bone and has been extensively documented in the appendicular skeleton. The mean age of inci- dence in the fourth decade, which is two decades later than the mean age of its appendicular counterpart.…”