Volume 5, 2019
|Number of page(s)||5|
|Published online||27 September 2019|
Locally aggressive monostotic fibrous dysplasia of the cervical spine mimicking malignancy: a case report and literature review
Department of Radiology, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France
2 Department of Pathology, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France
3 Department of Pathology, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
4 Department of Neurosurgery, Fondation Ophtalmologique de Rothschild, 29 rue Manin, 75019 Paris, France
5 Department of Rheumatology, Hôpital La Croix Saint-Simon, 125 rue d’Avron, 75020 Paris, France
* Corresponding author: firstname.lastname@example.org
Accepted: 7 July 2019
We report the case of a 30-year-old woman with histologically proven monostotic fibrous dysplasia of C2 revealed by a pathological fracture of the odontoid process. Radiological investigations showed a ground-glass mineralization of the vertebral body, a centimetric lytic area with poorly defined margins involving the inferior part of the vertebral body and inferior endplate and a fracture through an osteolytic area in the base of the odontoid process.
Owing to the vertebral instability, a surgical procedure combining C0–C5 fixation and posterior bone grafting was performed. The surgical biopsy was inconclusive and pathological confirmation was finally obtained through a percutaneous needle biopsy under fluoroscopic guidance. At 26-month follow-up, the patient still experienced mild persistent cervical posterior neck pain and stiffness possibly related to a C5–6 laxity below the intervertebral fixation.
This case combines three radiological findings, which are unusual in fibrous dysplasia: monostotic presentation involving the spine, some aggressive radiographic features, and a pathological fracture.
Key words: Monostotic fibrous dysplasia / Cervical spine / Pathological fracture / Aggressive
© The Authors, published by EDP Sciences, 2019
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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