Primary telangiectatic osteosarcoma of the cervical spine.
Telangiectatic osteosarcoma (TOS) is one of the 8 subtypes of osteosarcoma that infrequently affects the spine. The radiopathological features of TOS overlap with those of more benign entities, most commonly the aneurysmal bone cyst), and therefore is a significant diagnostic challenge. It is a rare but well-described entity in the thoracolumbar and sacral spine, and to the authors' knowledge has not been previously reported in the cervical spine.   The authors report the case of a 15-year-old boy who presented with a 6-month history of neck pain and torticollis. He underwent preoperative glue embolization followed by a staged subtotal C-5 spondylectomy and posterior fusion for a C-5 vertebral body lytic expansile lesion. Histopathological examination showed the lesion to be TOS. The surgery was followed by adjuvant radiation and chemotherapy with a favorable outcome at the 1-year follow-up. This report reiterates that TOS is an important differential diagnosis for aneurysmal bone cyst and giant-cell tumor of the spine, as its biological behavior and clinical outcome differ from those of these more benign lesions, which it mimics.
Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Mazda K
MK
Turel
Vivek
V
Joseph
Vandita
V
Singh
Vinu
V
Moses
Vedantam
V
Rajshekhar
D000293:Adolescent; D000792:Angiography; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D012516:Osteosarcoma / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D012086:Reoperation; D013125:Spinal Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000473:pathology