Solitary osteochondroma of the twelfth rib with intraspinal extension and cord compression in a middle-aged patient

• Published in: BMC musculoskeletal disorders 2012-04, Vol.13 (1), p.57-57, Article 57
• Main Authors: Shim, Jung Hyun, Park, Choon Keun, Shin, Seung Ho, Jeong, Hee Sun, Hwang, Jang Hoe
• Format: Article
• Language: English
• Subjects: Adolescent; Bone Neoplasms - complications; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - pathology; Bone Neoplasms - surgery; Bones; Care and treatment; Cartilage; Case Report; Child; CT imaging; Diagnosis; Female; Humans; Laminectomy; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; Medical imaging; Medical research; Medicine, Experimental; Middle age; Middle Aged; Musculoskeletal diseases; Neoplasm Invasiveness; Osteochondroma; Osteochondroma - complications; Osteochondroma - diagnostic imaging; Osteochondroma - pathology; Osteochondroma - surgery; Osteotomy; Patient outcomes; Predictive Value of Tests; Ribs - diagnostic imaging; Ribs - pathology; Ribs - surgery; Spinal cord; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - etiology; Spinal Cord Compression - surgery; Spinal Fusion; Surgery; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - pathology; Thoracic Vertebrae - surgery; Tomography, X-Ray Computed; Treatment Outcome; Tumors; Vertebrae; Young Adult
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/1471-2474-13-57

Osteochondroma is a disease of growing bone and thus typically presents in younger patients. It has rarely been described in middle-aged and elderly patients. Data on the occurrence of osteochondroma show that the reported incidence of costal osteochondroma is very low. Moreover, costal osteochondroma arising at the costovertebral junction with neural foraminal extension and spinal cord compression is extremely rare. This study reports the case of a 58-year-old patient with a solitary osteochondroma of the 12th rib with intraspinal extension and spinal cord compression. The clinical history, plain radiographs, computed tomography (CT), magnetic resonance imaging, and pathologic findings of the reported patient have been reviewed. The relevant medical literature has also been reviewed. The patient was treated with surgery for complete tumour excision to avoid tumour recurrence. After surgery, the patient's symptoms improved. An additional CT scan obtained at 1 year after surgery did not show any evidence of recurrence. This patient is the oldest patient reported to have this rare form of costal osteochondroma. The age of the patient and the erosion of the adjacent bones raised clinical suspicion of malignancy; therefore, surgical management involved complete tumour excision with thoracolumbar fixation and fusion.