Missed radiographic and clinical findings in a case of non-idiopathic scoliosis resulting from chondroblastoma

Navraj S. Sagoo, Edward P. Southern, Andrew G. King, Matthew W. Stark, Lori A. McBride

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Chondroblastoma is a cartilaginous neoplasm which rarely presents in the spine, where it has been shown to exhibit aggressive behavior. We present a case of a late diagnosis of a T12 chondroblastoma causing paraparesis in an 11-year-old girl. Several missed classical radiographic and clinical features are highlighted. Methods: We reviewed clinical, imaging, and pathology data from the time of transfer to our institution, followed by review of all outside clinical records and imaging data from 14 months prior to admission until onset of paraplegia. Results: The patient was transferred to our center for emergent treatment of a large, expansile, exophytic lesion compressing the spinal cord at T12. Intravenous steroids improved her neurologic status to ASIA Grade B, and an en bloc posterior element resection was performed emergently within 24 h. She rapidly improved to an ASIA Grade E. After obtaining all prior imaging during detailed histopathologic work-up, the final diagnosis was that of spinal chondroblastoma. Subsequent anterior en bloc resection was performed. The patient remains disease-free with a stable, residual scoliosis 7 years postoperatively. Conclusions: Detailed review of radiographs is essential for scoliosis patients. Earlier recognition of the "winking owl" sign, a kyphotic sagittal alignment, and more concern about a child with a painful curve may have resulted in earlier diagnosis before the onset of neurologic deficits.

Original languageEnglish (US)
Pages (from-to)297-301
Number of pages5
JournalSpine Deformity
Volume9
Issue number1
DOIs
StatePublished - Jan 2021
Externally publishedYes

Keywords

  • Chondroblastoma
  • Scoliosis
  • Spine
  • Tumor

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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