Back pain and osteolysis of the thoracic spine in an adult: a case of monostotic fibrous dysplasia masquerading as spinal metastasis

Isolated involvement of vertebra with fibrous dysplasia is rarely seen. We present a case of a 53 year old lady who presented with an 8-month history of pain in the thoracic region with paraparesis which required assistance for ambulation. She had a history of papillary thyroid carcinoma underwent t...

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Bibliographic Details
Main Authors: Zakaria@Mohamad, Zamzuri, Sharifudin, Mohd Ariff, Mohamed Amin, Mohamed Azril, Abd. Aziz, Azian, Khan, Ed Simor, Goh, Kian Liang
Format: Conference or Workshop Item
Language:English
English
Published: 2013
Subjects:
Online Access:http://irep.iium.edu.my/31837/1/APOA_2013_-_Spinal_Fibrous_Dysplasia_-_Dr_Ariff.pdf
http://irep.iium.edu.my/31837/17/Back_Pain_and_Osteolysis_of_the_Thoracic_Spine_in_an_Adult_%E2%80%93_a_Case_of_Monostotic_Fibrous_Dysplasia_Masquerading_as_Spinal_Metastasis.pdf
http://irep.iium.edu.my/31837/
http://www.apoa2013.org/
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Summary:Isolated involvement of vertebra with fibrous dysplasia is rarely seen. We present a case of a 53 year old lady who presented with an 8-month history of pain in the thoracic region with paraparesis which required assistance for ambulation. She had a history of papillary thyroid carcinoma underwent total thyroidectomy 1 year prior to her current problem. MR imaging revealed isolated osteolytic lesion over posterior element of T12 vertebra with narrowing of the spinal canal causing compression to the cord. CT-guided biopsy did not obtain any malignant cells. Patient underwent posterior decompression with fusion and stabilization between T10 to L2 with pedicle screw system. Posterior element of T12 and bilateral erector spinae muscles sent for histopathological evaluation. The diagnosis of fibrous dysplasia was made histologically. Five months post-surgery, the patient’s condition improved gradually. Fibrous dysplasia occurs rarely in axial bones than peripheral bones. This case illustrate that osteolytic lesion of the vertebrae should be evaluated with detailed radiological and histopathological examination before an empirical diagnosis of spinal metastasis is made in an adult with a background history of primary malignancy well-known to spread to the bone.