Martina Giordano1, Valerio Maria Caccavella2, Antonio Leone3, Nicola Montano2, Marco Gessi4, Alessandro Olivi2, Filippo Maria Polli2. 1. Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: msmgiordano@gmail.com. 2. Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 3. Institute of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 4. Institute of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
BACKGROUND: Osteoblastomas are rare primary bone tumors with a predilection for the spine. The extraosseous growth pattern is rare, and to our knowledge, only 2 cases of fully extraosseous osteoblastomas have been previously reported. CASE DESCRIPTION: A man aged 36 years presented with a 7-month history of low back pain radiating to the gluteal area. On examination, a typical L5 radiculopathy was noted. The radiologic examinations conducted in the previous months pointed out the rapid growth of an extraosseous mass occluding the right L5-S1 foramen. Partial laminectomy was performed to achieve gross total resection. Histological analysis was consistent with osteoblastoma. CONCLUSIONS: Osteoblastomas with extraosseous extension are uncommon, and an exclusively extraosseous presentation is anecdotal. This can lead to preoperative misdiagnosis when typical radiologic characteristics of bone-forming tumors are missing. We describe the case of an extraosseous lumbar osteoblastoma whose clinical and radiologic presentation was suggestive of malignancy.
BACKGROUND:Osteoblastomas are rare primary bone tumors with a predilection for the spine. The extraosseous growth pattern is rare, and to our knowledge, only 2 cases of fully extraosseous osteoblastomas have been previously reported. CASE DESCRIPTION: A man aged 36 years presented with a 7-month history of low back pain radiating to the gluteal area. On examination, a typical L5 radiculopathy was noted. The radiologic examinations conducted in the previous months pointed out the rapid growth of an extraosseous mass occluding the right L5-S1 foramen. Partial laminectomy was performed to achieve gross total resection. Histological analysis was consistent with osteoblastoma. CONCLUSIONS:Osteoblastomas with extraosseous extension are uncommon, and an exclusively extraosseous presentation is anecdotal. This can lead to preoperative misdiagnosis when typical radiologic characteristics of bone-forming tumors are missing. We describe the case of an extraosseous lumbar osteoblastoma whose clinical and radiologic presentation was suggestive of malignancy.