Management of a thoracic osteoblastoma revealed by slowly progressive spinal cord compression: A case report

Background: Osteoblastoma is a rare benign bone tumor accounting for approximately 1% of all primary bone tumors. Accurate diagnosis is essential for determining the most appropriate treatment strategy and prognosis. In most cases, diagnosis is based on clinical, radiological, and especially histopathological findings. The radiological appearance of osteoblastoma is highly variable, ranging from indolent lesions to locally aggressive tumors. We report the case of a 31-year-old woman presenting with a D12 osteoblastoma causing intercostal neuralgia and progressive paraparesis.
Case Description: A 31-year-old woman with no significant medical or surgical history presented with symptoms of spinal cord compression evolving over a six-month period. Thoracic CT and MRI demonstrated a lytic lesion involving the posterior portion of the vertebral body and the right pedicle of the D12 vertebra. An emergency D12 laminectomy and biopsy were initially performed. Because of the highly hemorrhagic nature of the lesion observed intraoperatively, definitive tumor excision and spinal fixation were scheduled as a second-stage procedure. Postoperatively, the patient experienced significant neurological improvement, including recovery from paraparesis and reduction of dorsal pain.
Conclusion: Early and appropriate surgical management of thoracic osteoblastoma resulted in a favorable clinical outcome.