Purpose
The purpose of this exhibit was to characterize radiography,
CT and MR imaging findings of benign notochordal cell tumors (BNCTs) versus chordoma,
useful to lead to the right diagnosis.
We report on a 59-year–old patient,
who underwent the whole diagnostic imaging iter,
finally confirmed by histological data.
Methods and Materials
A 59-years-old man was admitted to the Institute of Orthopaedics of our university with a 3-years history of thoracolumbar pain,
going worse during the last 3 months and followed by deficit in strength and functional limitation.
He reported on the diagnosis of “atypical” chordoma,
made elsewhere after histological examination.
At first,
radiographic examination of thoracic and lumbar spine was performed.
Afterwards,
he underwent thoracic CT examination and whole-spine MR imaging.
Finally,
the diagnosis was made by CT guided-biopsy and histological data: BNCT.
He was treated...
Results
Lateral radiograph of thoraco-lumbar spine showed only a mild area of osteolysis in T12 vertebral body (Fig.1),
without osteosclerotic rim,
bulging of the cortex or visible calcifications inside.
CT scan,
aimed to the thoracolumbar stretch,
demonstrated a mild dense area in the posterior half of the T12 vertebral body,
partially sclerotic,
with lobulated and regular edges,
involving the posterior wall and the right pedicle (Fig.2a,
2b),
showing moderate post-contrast enhancement (Fig.2c).
The lesion was mainly well defined .
MR imaging of the whole spine showed...
Conclusion
In summary,
we presented a case of a suspected "atypical" chordoma,
in an unusual site (T12 vertebra),
then turned out to be multicentric BNCT in thoracic vertebrae.
The differential diagnosis between BNCT and chordoma was made partially by CT and MR imaging,
because of the quite similar primary appearance of these lesions.
Hystological confirmation has been irreplaceable and decisive to support the radiological findings in order not to loose the right diagnosis.
It's fundamental to manage properly the right surgical or conservative therapy.
Clinical and...
References
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Yamaguchi T,
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Saotome K.
First histologically confirmed case of a classic chordoma arising in a precursor benign...