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M9650368.TXT
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1996-03-09
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Document 0368
DOCN M9650368
TI Primary xanthoma of thoracic spine presenting with myelopathy.
DT 9605
AU Robertson DP; Langford LA; McCutcheon IE; Department of Neurosurgery,
University of Texas M. D. Anderson; Cancer Center, Houston, USA.
SO Spine. 1995 Sep 1;20(17):1933-7. Unique Identifier : AIDSLINE
MED/96060156
AB STUDY DESIGN. This retrospective case study reports on a patient with an
isolated primary xanthoma arising in the second thoracic vertebra with
paravertebral and spinal canal extension. OBJECTIVE. The possibility of
this lesion's occurrence in the spine is presented with radiologic and
pathologic findings appropriate for the diagnosis of spinal xanthoma.
SUMMARY OF BACKGROUND DATA. Primary xanthoma of bone is an extremely
rare but benign entity. It has not been previously described in this
location, and has been described only once in the spine at all. METHODS.
The mass was resected by curettage, and posterior instrumentation was
successfully performed. Preoperative radiographs and magnetic resonance
imaging of the thoracic spine were performed, as was histologic
examination of the lesion. RESULTS. Radiographs of the upper thoracic
spine revealed a lytic defect. Magnetic resonance imaging revealed a
heterogeneous lesion that was enhanced upon the administration of
gadolinium-diethylenetriaminetetraacetic acid. Histologic examination
revealed a cellular lesion consisting of lipid-laden macrophages,
fibroblasts, and scattered Touton giant cells. These features correspond
to descriptions of primary xanthoma of bone. Two years after surgery,
the patient was neurologically intact with no evidence the lesion would
recur. CONCLUSIONS. Primary xanthoma of bone is considered a benign
lesion and can be successfully treated by local resection without
adjuvant therapy. It should be considered part of the differential
diagnosis of a mass lesion, with appropriate signal characteristics
presenting in a thoracic vertebra.
DE Adult Case Report Diagnosis, Differential Human Male Paraparesis,
Tropical Spastic/DIAGNOSIS/*ETIOLOGY/SURGERY Spinal
Diseases/COMPLICATIONS/DIAGNOSIS/SURGERY *Thoracic Vertebrae/SURGERY
Xanthomatosis/*COMPLICATIONS/DIAGNOSIS/SURGERY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).