Primary intraosseous xanthogranuloma in adult cervical spine: A case report of benign cause of lytic bone lesion

Abstract

Lytic lesions in adult spine are a common manifestation of aggressive disease such as primary bone tumor, metastasis, myeloma, or infectious pathology. Xanthoma arising in the spine with purely intraosseous component is an extremely rare occurrence with only six cases reported in the adult population, none in the cervical region. We report the first case of primary xanthoma of the cervical spine in a 50-year-old male solely confined to osseous compartment. The imaging mimics of lytic lesion with expansile mass in adult spine are reiterated.

Cervical Myelopathy due to Odontoid Fracture Induced by Spinal Involvement of Xanthoma Disseminatum

“…Both lytic and sclerotic lesions in imaging studies have been reported. However, there have been few previous reports describing the histopathological findings in skeletal lesions 8,10 . In this case, features of the lesion obtained from the retro-odontoid mass were similar to those from a tumor that bulged posteriorly from the C1-C2 facet joint.…”

“…C ervical spine involvement in patients with XD has rarely been reported 10 . XD with skeletal involvement usually follows a slow clinical course similar to its progression in other tissues.…”

“…Relatively rare manifestations of XD with bone and joint involvement have been reported in the knee, hip, hands, and forearms [5][6][7][8][9] . However, spinal joint involvement in XD has rarely been reported 10,11 . Here, we report a case of odontoid pathological fracture as a rare manifestation of XD, resulting in cervical myelopathy that required posterior atlantoaxial fusion with screw-rod constructs and autologous bone transplantation.…”