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Open Access Case report

Solitary osteochondroma of the twelfth rib with intraspinal extension and cord compression in a middle-aged patient

Jung Hyun Shim1*, Choon Keun Park1, Seung Ho Shin1, Hee Sun Jeong2 and Jang Hoe Hwang1

Author Affiliations

1 Department of Neurosurgery, The Leon Wiltse Memorial Hospital, Suwon, Korea

2 Department of Radiology, The Leon Wiltse Memorial Hospital, Suwon, Korea

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BMC Musculoskeletal Disorders 2012, 13:57  doi:10.1186/1471-2474-13-57

Published: 13 April 2012

Abstract

Background

Osteochondroma is a disease of growing bone and thus typically presents in younger patients. It has rarely been described in middle-aged and elderly patients. Data on the occurrence of osteochondroma show that the reported incidence of costal osteochondroma is very low. Moreover, costal osteochondroma arising at the costovertebral junction with neural foraminal extension and spinal cord compression is extremely rare.

Case presentation

This study reports the case of a 58-year-old patient with a solitary osteochondroma of the 12th rib with intraspinal extension and spinal cord compression. The clinical history, plain radiographs, computed tomography (CT), magnetic resonance imaging, and pathologic findings of the reported patient have been reviewed. The relevant medical literature has also been reviewed. The patient was treated with surgery for complete tumour excision to avoid tumour recurrence. After surgery, the patient's symptoms improved. An additional CT scan obtained at 1 year after surgery did not show any evidence of recurrence.

Conclusions

This patient is the oldest patient reported to have this rare form of costal osteochondroma. The age of the patient and the erosion of the adjacent bones raised clinical suspicion of malignancy; therefore, surgical management involved complete tumour excision with thoracolumbar fixation and fusion.