Citation

Khin YT, Peh WCG, Chang KTE, Mya SN (2018) High-Grade Primary Osteosarcoma of the Thoracic Spine Presenting as an Ivory Vertebra. Int J Cancer Clin Res 5:099. doi.org/10.23937/2378-3419/1410099

Copyright

© 2018 Khin YT, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESSDOI: 10.23937/2378-3419/1410099

High-Grade Primary Osteosarcoma of the Thoracic Spine Presenting as an Ivory Vertebra

Khin YT1*, Peh WCG2, Chang KTE3 and Mya SN4

1Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Republic of Singapore

2Senior Consultant, Clinical Professor and Head, Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Republic of Singapore

3Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Republic of Singapore

4Department of Paediatric Oncology/Haematology, KK Women's and Children's Hospital, Republic of Singapore

Abstract

We report a 12-year-old Chinese girl with high-grade osteosarcoma of the thoracic spine, a rare site for a rare tumour. Radiograph showed a dense T9 vertebral body resembling an ivory vertebra. Bone scintigraphy revealed abnormal tracer uptake in the T9 vertebral body and posterior elements. Magnetic resonance imaging showed T1- and T2- hypointense signal in the T9 vertebral body and the posterior elements, with diffuse enhancement. There was an associated heterogeneously-enhancing paravertebral soft tissue component surrounding the T9 vertebral body and the posterior elements, which extended into the epidural space encasing the thecal sac, spinal cord and bilateral intervertebral foramina. Computed tomography showed patchy but extensive mineralisation of all these soft tissue components. She was treated with T9 corpectomy, cord decompression and posterior instrumentation, followed by chemotherapy, with subsequent clinical improvement. The radiological features and differential diagnosis of thoracic spine osteosarcoma are discussed.