Sakarya University Faculty of Medicine, Sakarya, Turkey.
Department of Pathology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey.
JBJS Case Connect. 2023 Sep 8;13(3). doi: 10.2106/JBJS.CC.23.00307. eCollection 2023 Jul 1.
A 22-year-old female patient was referred to the orthopaedic department for further examination after a radiopaque area was observed in the T6 vertebra in her chest radiograph. Computed Tomography (CT) showed a sclerotic mass with smooth borders, involving the entire body of the T6 vertebra, left posterior elements, posterior of the rib past the left zygapophyseal joint, and a "flowing candle wax" image toward the T7 vertebra. Spinal melorheostosis was considered radiologically in the patient, but malignancy could not be completely excluded. Thereupon, open biopsy was performed under general anesthesia.
Spinal melorheostosis is a rare condition. Histological examination should be considered in cases where the diagnosis remains suspicious after clinical and radiological evaluations.
患者为 22 岁女性,胸部 X 线片示 T6 椎体有不透射线区,遂转诊至骨科进一步检查。计算机断层扫描(CT)显示 T6 椎体整个体部、左侧后结构、越过左侧椎间关节的肋骨后部存在一个边界光滑的硬化性肿块,呈“蜡烛样流注”样向 T7 椎体延伸。患者影像学上考虑为脊柱弥漫性骨质肥厚症,但不能完全排除恶性肿瘤。于是,在全身麻醉下进行了开放性活组织检查。
脊柱弥漫性骨质肥厚症较为罕见。在临床和影像学评估后仍怀疑诊断时,应考虑进行组织学检查。