Imaging characteristics of a rare case of monostotic fibrous dysplasia of the sacrum: A case report.

Case report Computed tomographic Fibrous dysplasia Magnetic resonance imaging Monostotic Sacrum Spine

Journal

World journal of clinical cases
ISSN: 2307-8960
Titre abrégé: World J Clin Cases
Pays: United States
ID NLM: 101618806

Informations de publication

Date de publication:
16 Feb 2021
Historique:
received: 29 08 2020
revised: 14 11 2020
accepted: 06 12 2020
entrez: 1 3 2021
pubmed: 2 3 2021
medline: 2 3 2021
Statut: ppublish

Résumé

Fibrous dysplasia (FD) is a common benign intramedullary fibro-osseous lesion. Involvement of the spine is rare, with the literature including only case reports, and cases of monostotic FD (MFD) in the sacrum are extremely rare. A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment. We retrospectively assessed a case report of MFD in the sacrum. This patient was examined by computed tomography (CT) and magnetic resonance imaging (MRI), and the diagnosis was confirmed by pathology. A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD. For our patient, the CT scan showed the lesion to be expansile, with ground glass opacity and a sclerotic rim. On MRI, the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI. A low signal rim was found on T1WI and T2WI. Our patient was treated by posterior focal excision, decompression, bone grafting, fusion and pedicle screw fixation. A satisfactory result was achieved, with pain disappearance. No complications had occurred at the 1-year follow up. MFD is an expansile osteolytic change. Ground glass opacity and a sclerotic margin are obvious characteristics. The lesion often involves the vertebral body and posterior element. Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.

Sections du résumé

BACKGROUND BACKGROUND
Fibrous dysplasia (FD) is a common benign intramedullary fibro-osseous lesion. Involvement of the spine is rare, with the literature including only case reports, and cases of monostotic FD (MFD) in the sacrum are extremely rare. A correct preoperative diagnosis of spinal MFD is important for clinicians to select proper treatment.
CASE SUMMARY METHODS
We retrospectively assessed a case report of MFD in the sacrum. This patient was examined by computed tomography (CT) and magnetic resonance imaging (MRI), and the diagnosis was confirmed by pathology. A review of the literature was performed to analyze the imaging characteristics and differential diagnoses of spinal MFD. For our patient, the CT scan showed the lesion to be expansile, with ground glass opacity and a sclerotic rim. On MRI, the lesion showed iso-low signal intensity on T1WI and iso-high signal intensity on T2WI. A low signal rim was found on T1WI and T2WI. Our patient was treated by posterior focal excision, decompression, bone grafting, fusion and pedicle screw fixation. A satisfactory result was achieved, with pain disappearance. No complications had occurred at the 1-year follow up.
CONCLUSION CONCLUSIONS
MFD is an expansile osteolytic change. Ground glass opacity and a sclerotic margin are obvious characteristics. The lesion often involves the vertebral body and posterior element. Knowledge of these imaging characteristics of spinal FD could be helpful for diagnosis and prevent unnecessary procedures.

Identifiants

pubmed: 33644174
doi: 10.12998/wjcc.v9.i5.1111
pmc: PMC7896654
doi:

Types de publication

Case Reports

Langues

eng

Pagination

1111-1118

Informations de copyright

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Références

J Bone Joint Surg Am. 2011 Jul 6;93(13):e74
pubmed: 21776559
Asian J Neurosurg. 2015 Jul-Sep;10(3):216-8
pubmed: 26396610
J Bone Joint Surg Am. 2010 Apr;92(4):984-8
pubmed: 20360526
J Back Musculoskelet Rehabil. 2016 Apr 27;29(2):387-391
pubmed: 26577280
Neurosurgery. 2011 Dec;69(6):1171-80
pubmed: 21725252
Childs Nerv Syst. 2016 May;32(5):873-6
pubmed: 26732064
Am J Med. 1968 Mar;44(3):421-9
pubmed: 5644094
Malays J Med Sci. 2016 Jan;23(1):82-6
pubmed: 27540330
Clin Radiol. 1988 Sep;39(5):523-7
pubmed: 3180670
J Korean Neurosurg Soc. 2011 Aug;50(2):139-42
pubmed: 22053236
Skeletal Radiol. 2020 Jun;49(6):837-845
pubmed: 32040603
Spine (Phila Pa 1976). 2013 Nov 1;38(23):2016-22
pubmed: 23970113
AJR Am J Roentgenol. 1996 Dec;167(6):1523-7
pubmed: 8956590
Skeletal Radiol. 2015 Jan;44(1):25-36
pubmed: 25348558
N Engl J Med. 1991 Dec 12;325(24):1688-95
pubmed: 1944469
Spine (Phila Pa 1976). 1987 Nov;12(9):939-42
pubmed: 3327174
J Bone Joint Surg Am. 2005 Aug;87(8):1848-64
pubmed: 16085630
Acta Med Port. 2019 Jun 28;32(6):466-468
pubmed: 31292029
Br J Radiol. 2012 Jul;85(1015):996-1001
pubmed: 22167510
Spine (Phila Pa 1976). 1992 Aug;17(8):977-9
pubmed: 1523499
Radiol Med. 2014 Sep;119(9):681-93
pubmed: 24531890

Auteurs

Xin-Xin Liu (XX)

MRI Department, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.

Xin Xin (X)

Department of Orthopaedics, Ankang Center Hospital, Ankang 725000, Shaanxi Province, China.

Yu-Hong Yan (YH)

MRI Department, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.

Xiao-Wen Ma (XW)

MRI Department, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China. yxmxw@126.com.

Classifications MeSH