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

Zakaria@Mohamad, Zamzuri and Sharifudin, Mohd Ariff and Mohamed Amin, Mohamed Azril and Abd. Aziz, Azian and Khan, Ed Simor and Goh, Kian Liang (2013) Back pain and osteolysis of the thoracic spine in an adult: a case of monostotic fibrous dysplasia masquerading as spinal metastasis. In: 9th Asia Pacific Spine Society Congress, 29-31 Aug 2013, Pullman Kuching, Sarawak, Malaysia.

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Abstract

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.

Item Type:	Conference or Workshop Item (Slide Presentation)
Additional Information:	3660/31837
Uncontrolled Keywords:	Back pain, osteolysis, thoracic spine, adult, fibrous dysplasia , spinal metastasis
Subjects:	R Medicine > RB Pathology R Medicine > RC Internal medicine > RC254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RD Surgery > RD701 Orthopedics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Department of Orthopaedics, Traumatology & Rehabilitation
Depositing User:	DR MOHD ARIFF SHARIFUDIN
Date Deposited:	19 Sep 2013 13:33
Last Modified:	20 Dec 2018 08:11
URI:	http://irep.iium.edu.my/id/eprint/31837

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