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Subperiosteal Osteoblastoma of the Spine: A Familiar Player in an Unusual Location 2011

General Spine

Amish, H, Doshi, MD
Kapil, R, Desai, MD, Non ASSR Member
Sheeraz, Qureshi, MD, MBA, Non ASSR Member
James, C, Wittig, MD, Non ASSR Member

Excerpta

A 29-year-old male radiology resident presented with a several month history of lower back pain which was worse at night and improved with non-steroidal anti-inflammatories. A CT and MRI were performed which demonstrated the presence of a small ossific focus (black arrow) overlying the junction of the right L1 lamina with its respective spinous process. A small amount of reactive sclerosis and edema were identified within the lamina on the CT and MR (white arrow), respectively. This focus demonstrated significant uptake on technetium-labeled bone scan. It was unclear at this time whether this focus resided within bone or was centered in the ligamentous structures. Surgical exploration, resection and pathologic analysis demonstrated the presence of a subperiosteal osteoblastoma. Osteoblastomas are a rare, painful tumor of the spine. To our knowledge, there have been no reported cases of subperiosteal osteoblastoma within the spine. Though, osteoblastomas have a typical appearance on cross-sectional imaging, when it occurs in an subperiosteal location recognition and diagnosis can be confusing. Awareness of this entity and this unusual presentation can lend to accurate future diagnosis.

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