J Korean Soc Spine Surg.  2013 Sep;20(3):118-122. 10.4184/jkss.2013.20.3.118.

Primary Osteosarcoma of the Thoracic Vertebra: A Case Report

Affiliations
  • 1Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea. boscoa@catholic.ac.kr

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
To report a case of osteosarcoma involving the thoracic spine in an elderly patient. SUMMARY OF LITERATURE REVIEW: Spinal osteosarcoma has been reported as a relatively low incidence (3-5%) of musculoskeletal osteosarcoma. Dominant histologic type was osteoblastic. Radical excision or palliative excision followed by adjuvant chemotherapy and radiation therapy was tried. The overall prognosis was shown to be poorer than osteosarcomas in other skeletal areas.
MATERIALS AND METHODS
A review of clinical and radiologic data of osteosarcoma involving the 12th thoracic spine that were confirmed by histopathology.
RESULTS
Palliative surgery followed by adjuvant radiation therapy and chemotherapy was performed.
CONCLUSIONS
We report here the clinical and radiological findings of a case of osteosarcoma that arose in the thoracic spine with a literature review.

Keyword

Vertebra; Osteosarcoma

MeSH Terms

Aged
Chemotherapy, Adjuvant
Humans
Incidence
Osteoblasts
Osteosarcoma
Palliative Care
Prognosis
Spine

Figure

  • Fig. 1. (A) TL spine AP & lateral radiographs shows the loss of right side pedicle and collapse of T12 (arrow). (B) Bone scintigraphy shows the abnormal hot uptake at T12 that is corresponding to other radiologic findings.

  • Fig. 2. (A) MRI shows heterogenous signal mass of the T12 and posterior portion of T11 body and extraspinal mass extending to spinal canal and neural foramen. (B) PET-CT shows no abnormal FDG-uptake except for the T11 & T12 spine.

  • Fig. 3. (A) Palliative surgery with posterior decompression and stabilization was performed. (B) Postoperative 3 months radiographs show collapse of T12 vertebral body without significant loss of stabilization.

  • Fig. 4. Microscopic finding shows tumor cells with oval or spindle-shaped nucleus and mitosis. Multiple giant cells like osteoclasts (arrow) are also seen. Osteoid formation (arrow head) and necrotic tissue formation are evident (HE stain, ×200).


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