Lakemeier Stefan, Westhoff Christina Carolin, Fuchs-Winkelmann Susanne, Schofer Markus Dietmar
Department of Orthopaedics, University Hospital Giessen and Marburg, Location Marburg, Baldingerstrasse, 35033 Marburg, Germany.
J Med Case Rep. 2009 Nov 2;3:92. doi: 10.1186/1752-1947-3-92.
We report the case of an osseous hemangioma located in the seventh cervical vertebra with reactive osteoid formation and non-typical findings in the radiological and the histopathological examination, mimicking metastasis of a malignant tumor. To our knowledge, this is the first description of such a case in the literature.
A 44-year-old otherwise healthy Caucasian German woman presented with a discrete sensorimotor loss of both upper limbs. Radiologically, an osteolysis in the seventh cervical vertebra suggestive of metastasis of a malignant neoplasm was diagnosed. After performing corporectomy and cage implantation of C7 on the patient, the histopathological examination was complicated by marked osteoid formation obscuring the true diagnosis of an osseous hemangioma with reactive osteoid formation.
Though hemangioma of the bone is a rare tumorous lesion in the cervical spine, it has to be taken into consideration as a reason for neck pain and sensomotoric loss of the upper limbs. Atypical radiological and histopathological presentations may hinder determination of the correct diagnosis. The treatment of such lesions must follow clinical guidelines but may be difficult to define in some cases when the correct diagnosis is not known at the time when therapy starts.
我们报告了一例位于第七颈椎的骨血管瘤病例,该病例在影像学和组织病理学检查中伴有反应性类骨质形成及非典型表现,酷似恶性肿瘤转移。据我们所知,这是文献中对该类病例的首次描述。
一名44岁、身体健康的德国白人女性,出现双上肢轻度感觉运动功能丧失。影像学检查诊断为第七颈椎骨质溶解,提示恶性肿瘤转移。对该患者进行C7椎体切除及椎间融合器植入术后,组织病理学检查因显著的类骨质形成而变得复杂,掩盖了伴有反应性类骨质形成的骨血管瘤的真正诊断。
尽管骨血管瘤是颈椎中罕见的肿瘤性病变,但必须将其视为颈部疼痛和上肢感觉运动功能丧失的原因之一。非典型的影像学和组织病理学表现可能会妨碍正确诊断的确立。此类病变的治疗必须遵循临床指南,但在某些情况下,当治疗开始时正确诊断尚不明确时,治疗方案可能难以确定。