![]() The lesion was resectioned in two parts, about 3 cm × 3 cm × 2.5 cm in total ( Fig. The adherence between the osteochondroma cap and the membrana pleuralis was broken during separation and should heal naturally. The osteocartilaginous tumor originating from the transverse process was radically excised and surgical curettage of the lesion performed. The patient underwent a backside incision with about cm of the eighth and ninth ribs excised from the back. It shelled out easily however, the former part within the thoracic cage was more difficult to remove ( Fig. It was adherent to the lateral aspect of the vertebral body and adjacent to pleura and aorta. The aspiration-needle biopsy results showed the existence of cartilage cells.ĭuring the surgery, the back part of the lesion resembled a pearly brown marble. A mild improvement of the lesion is seen on the post-contrast sagittal T1-weighted images ( Fig. A thin hypointense rim surrounding the lesion on T1-weighted images represented a thin shell of cortical bone surrounding the lesion. The lesion was isointense with the adjacent vertebral body marrow on T2-weighted images and slightly hyperintense to normal marrow on T1-weighted images. Magnetic resonance imaging (MRI) of the spine showed a giant mass lesion involving the transverse process of T8 and concomitant corresponding vertebral body and rib on the left side. A 3D reconstruction of the CT results also confirmed it was an osteochondroma coming from the transverse process ( Fig. This suggested a primary bone tumor with a calcificated part evection into the thoracic cage ( Fig. Computed tomography (CT) of the thoracic spine, performed to further characterize the lesion, revealed high attenuation, arising from the left lateral aspect of the T8 transverse process overlying the left eighth rib posteriorly, with central soft-tissue density and a calcified rim. ![]() An agglutination test for Salmonella and Brucella yielded negative results.Ī plain X-ray showed what appeared to be an uneven ovoid paraspinal mass at the level of T8 and T9 vertebrae ( Fig. The results of liver function tests and serum chemistry including blood glucose and urinalysis were normal. The erythrocyte sedimentation rate (ESR) was 13 mm/h (normal, < 15 mm/h), and the white blood cell (WBC) count was normal. Palpation results showed it was hard and about 1 cm × 2 cm in size. The location of the node was 1 cm on the left side of the transverse process. On physical examination, there was a considerable tenderness over the lower thoracic spine, but there was no neurological deficit. After a 1-month treatment of anti-inflammatory drugs, the symptoms had not subsided and the node had begun to increase in size and could be detected at the epidermis. We report on a 28-year-old man suffering from intermittent back pain due to a node in the thoracic vertebrae. The best choice of treatment for spinal osteochondromas is surgical excision or curettage and spinal stabilization, if necessary. The histological examination of this patient revealed the lesion was osteochondroma. It is concluded that accurate and prompt diagnosis requires a high index of suspicion followed by surgical treatment to prevent severe morbidity in cases of primary spinal column tumors. ![]() At surgery, a firm and cartilaginous tumor originating from the transverse process was radically excised and surgical curettage of the lesion was performed. Here we report a giant solitary osteochondroma arising from the thoracic transverse process of T8 vertebra and involving the corresponding transverse process and rib.Ī 28-year-old man presented with a progressive thoracic node, and neuroradiological evaluation of the spine showed a giant mass lesion involving the transverse process of T8 vertebra and concomitant corresponding facet joint and rib on the left side. An osteochondroma arising from the transverse process of the vertebra is even rarer, especially following from the thoracic transverse process. When they are found in the vertebral column, less than 1% of all osteochondromas and few tumors occur in the thoracic vertebrae. The incidence of osteochondroma is rare and only 2% of such tumors are found in the spine area.
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