Osteochondroma of Upper Dorsal Spine Causing Spastic Paraparesis in Hereditary Multiple Exostosis: A Case Report

An Unusual Presentation of Costal Intraspinal Osteochondroma Causing Compressive Myelopathy in a Patient With Hereditary Multiple Exostoses: A Case Report and Literature Review

A 22-year-old man presented to us with back pain for four months, inability to walk, and weakness in both lower limbs. Clinical examination revealed multiple swellings in the body, motor weakness, paresthesia, and upper motor neuron signs. Both magnetic resonance imaging (MRI) and computed tomography (CT) revealed an abnormal bone mass protruding into the spinal canal from the posterior aspect of the ninth rib through the D9-D10 neural foramen. After routine preoperative evaluation, the lesion was removed en masse along with the rib to which it was attached. Osteochondroma was the histological diagnosis. After the procedure, the patient's symptoms subsided, and he could return to his daily activities. From this case, we recommend performing whole spine MRI screening for all patients with hereditary multiple exostoses to diagnose intraspinal lesions that need to be addressed early to have a good postoperative outcome.

An unusual example of hereditary multiple exostoses: a case report and review of the literature

Background

Hereditary multiple exostoses (HME) is a rare skeletal disorder characterised by a widespread.

distribution of osteochondromas originating from the metaphyses of long bones.

Case presentation

This case study examines a 55-year-old male cadaver bequeathed to the University of Liverpool who suffered from HME, thus providing an exceptionally rare opportunity to examine the anatomical changes associated with this condition.

Conclusions

Findings from imaging and dissection indicated that this was a severe case of HME in terms of the quantity and distribution of the osteochondromas and the number of synostoses present. In addition, the existence of enchondromas and the appearance of gaps within the trabeculae of affected bones make this a remarkable case. This study provides a comprehensive overview of the morbidity of the disease as well as adding to the growing evidence that diseases concerning benign cartilaginous tumours may be part of a spectrum rather than distinct entities.

Multiple hereditary osteochondromatosis with spinal cord compression: case report

OBJECTIVE

The purpose of the report is to describe a patient with hereditary osteochondromatosis and spinal cord compression at the thoracic level.

CLINICAL FEATURES

An 8-year-old patient with hereditary osteochondromatosis inherited from his father presented paraparesis in the left foot, leading to complete paralysis in both legs.

INTERVENTION

In a CT scan, a bony tumor rising from the posterior wall of the T3 body narrowing the spinal canal, and the MRI spinal cord compression at the same level and the hydrosyringomyelic cavity extended to the conus medullaris; with an anterior thoracic approach to T2-T4, the fibro-cartilaginous tumor was removed, and the stabilization was completed with bone graft and a plate. Two months after surgery, the patient recovered strength in both legs.

CONCLUSIONS

A detailed family history through examination-guided advanced imaging and biopsy provides useful information for diagnosis and appropriate management of occupative lesions in patients affected with multiple hereditary exostosis.