23 May 2023>: Articles
A Case of an 82-Year-Old Man with a Spinal Extradural Malignant Ossifying Fibromyxoid Tumor
Challenging differential diagnosis, Rare disease
Qiqi Lu B* , Chi Long Ho ADOI: 10.12659/AJCR.939408
Am J Case Rep 2023; 24:e939408
Table 2. Summary of common primary spinal extradural tumors.
Primary spinal tumors | Prevalent age group | Common location | MRI features | Recurrence/metastasis |
---|---|---|---|---|
Lymphoma | Young adults | Extranodal, involved vertebral body and epidural space | T1 iso- and T2 hyper-intense with homogenous ‘cloud-like’ enhancement | Recurrence and metastasis are common |
Myeloid sarcoma | Children | Epidural soft tissue mass, lymph nodes | T1 and T2 isointense, and contrast enhancement | Recurrence and metastasis []17 |
Multiple myeloma | >40 years | Vertebral red marrow, epidural space, axial and proximal appendicular skeleton | T1 hypointense, T2 hyperintense with enhancement | Recurrence within 12 mths in 16% of cases; 84% recurrence after 1 year []. It commonly presents in disseminated form18 |
Hemangiopericytoma | Young adults | Solitary dural-extradural mass, in supratentorium and posterior fossa | T1- and T2-isointensities with avid enhancement and flow voids | Recurrence rate 3.5%, 46% and 92%, in 1, 5 and 15 years, respectively []. Extraneural metastasis 26% at an average 123 mths after initial surgery19 |
Chordoma | Young-middle age adults | Clival, spheno-occipital, midline sacrococcyx and vertebral body | T1 iso to hypo- and T2 hyper-intensities with heterogeneous enhancement | Local recurrence of spinal chordoma 19–54% []. Incidental metastases 3–48%20 |
Chondrosacroma | 4 and 5 decades | Posterior elements ± vertebral body, long bones and pelvis | Rim and arc calcification, T1 iso-hypointensity and intense T2 hyperintensity with heterogeneous enhancement and booming | Recurrence rate 20–58%. Metastasis 9.7–26.1% []21 |
Osteosacroma | Primary between 10–20 years; secondary in the elderly | Metadiaphysis of long bones, vertebra, flat bones like pelvis | Heterogeneous mass with T1 iso- and T2 hyper-intensities. Soft tissue components with enhancement and booming | Recurrence in one-third, and metastases in 30–40%, mostly to lungs []22 |
Giant cell tumor | Early adulthood | Long bones, vertebrae, sacrum | T1 iso to hypointense, T2 heterogenous hyperintense with enhancement. Involvement of adjacent vertebral marrow with high T2 signal with enhancement | Recurrence rates 15–60%. Metastasis to the lungs 1–9% []23 |
F – female; M – male; mths – months; RT – radiation therapy; y – years. |