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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 A

DOI: 10.12659/AJCR.939408

Am J Case Rep 2023; 24:e939408

Table 2. Summary of common primary spinal extradural tumors.

Primary spinal tumorsPrevalent age groupCommon locationMRI featuresRecurrence/metastasis
LymphomaYoung adultsExtranodal, involved vertebral body and epidural spaceT1 iso- and T2 hyper-intense with homogenous ‘cloud-like’ enhancementRecurrence and metastasis are common
Myeloid sarcomaChildrenEpidural soft tissue mass, lymph nodesT1 and T2 isointense, and contrast enhancementRecurrence and metastasis []17
Multiple myeloma>40 yearsVertebral red marrow, epidural space, axial and proximal appendicular skeletonT1 hypointense, T2 hyperintense with enhancementRecurrence within 12 mths in 16% of cases; 84% recurrence after 1 year []. It commonly presents in disseminated form18
HemangiopericytomaYoung adultsSolitary dural-extradural mass, in supratentorium and posterior fossaT1- and T2-isointensities with avid enhancement and flow voidsRecurrence rate 3.5%, 46% and 92%, in 1, 5 and 15 years, respectively []. Extraneural metastasis 26% at an average 123 mths after initial surgery19
ChordomaYoung-middle age adultsClival, spheno-occipital, midline sacrococcyx and vertebral bodyT1 iso to hypo- and T2 hyper-intensities with heterogeneous enhancementLocal recurrence of spinal chordoma 19–54% []. Incidental metastases 3–48%20
Chondrosacroma4 and 5 decadesPosterior elements ± vertebral body, long bones and pelvisRim and arc calcification, T1 iso-hypointensity and intense T2 hyperintensity with heterogeneous enhancement and boomingRecurrence rate 20–58%. Metastasis 9.7–26.1% []21
OsteosacromaPrimary between 10–20 years; secondary in the elderlyMetadiaphysis of long bones, vertebra, flat bones like pelvisHeterogeneous mass with T1 iso- and T2 hyper-intensities. Soft tissue components with enhancement and boomingRecurrence in one-third, and metastases in 30–40%, mostly to lungs []22
Giant cell tumorEarly adulthoodLong bones, vertebrae, sacrumT1 iso to hypointense, T2 heterogenous hyperintense with enhancement. Involvement of adjacent vertebral marrow with high T2 signal with enhancementRecurrence rates 15–60%. Metastasis to the lungs 1–9% []23
F – female; M – male; mths – months; RT – radiation therapy; y – years.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923