Benjamin Hughes W, Corliss Lauren E, Murray Taylor N, Chamberlin Gregory, Franklin Deveney, Attiah Mark A
School of Medicine, University of North Carolina at Chapel Hill, North Carolina.
Department of Pathology, University of North Carolina Hospitals, Chapel Hill, North Carolina.
J Neurosurg Case Lessons. 2025 Sep 15;10(11). doi: 10.3171/CASE25468.
Extraskeletal osteochondromas are well-circumscribed osteocartilaginous lesions arising from soft tissues without bone continuity. Extraskeletal osteochondromas may present in a para-articular location, although few reported cases have occurred near the spine. Clinical diagnosis remains challenging as these tumors can be difficult to distinguish from other ossified soft tissue lesions. Treatment includes management by observation or resection. Here the authors present a rare case of an extraskeletal osteochondroma near the cervical spine.
A 56-year-old male presented with a palpable left paraspinal suboccipital mass that had slowly progressed over 5 years. The patient was asymptomatic and the neurological examination was nonfocal. MRI revealed an approximately 6-cm well-circumscribed heterogeneous mass in the left suboccipital area that lacked direct contact with the spine or calvarium. A hypointense capsule on T2-weighted MRI and multiple hypointense septations on T1- and T2-weighted MRI were identified. The slow rate of tumor growth suggested a benign tumor. CT imaging of the chest, abdomen, and pelvis was obtained to rule out malignancy. Surgical intervention was offered and accepted by the patient. At 2 months postoperatively, imaging demonstrated no recurrence, and the patient was asymptomatic and had improved range of motion.
Extraskeletal osteochondroma should be considered when diagnosing osteocartilaginous paraspinal masses. https://thejns.org/doi/10.3171/CASE25468.
骨外生骨疣是起源于软组织且无骨连续性的边界清晰的骨软骨性病变。骨外生骨疣可出现在关节旁部位，尽管报道的病例很少发生在脊柱附近。由于这些肿瘤难以与其他骨化性软组织病变区分开来，临床诊断仍然具有挑战性。治疗方法包括观察或切除。在此，作者报告了一例罕见的颈椎旁骨外生骨疣病例。
一名56岁男性患者，左枕下脊柱旁可触及肿块，5年来缓慢增大。患者无症状，神经系统检查无局灶性异常。MRI显示左枕下区域有一个边界清晰的约6cm大小的不均匀肿块，与脊柱或颅骨无直接接触。T2加权MRI上可见低信号包膜，T1加权和T2加权MRI上可见多个低信号分隔。肿瘤生长缓慢提示为良性肿瘤。进行胸部、腹部和骨盆的CT成像以排除恶性肿瘤。患者接受了手术干预。术后2个月，影像学检查显示无复发，患者无症状，活动范围改善。
诊断脊柱旁骨软骨肿块时应考虑骨外生骨疣。https://thejns.org/doi/10.3171/CASE25468 。
