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  • Title: Lumbar spinal canal osteosarcoma: A case report.
    Author: Chen DJ, Lai Q, Zhu J, Wan Z, Liu H, Dai M, Guo R, Zhang B.
    Journal: Medicine (Baltimore); 2018 Jun; 97(25):e11210. PubMed ID: 29924047.
    Abstract:
    RATIONALE: Osteosarcoma is a rare neoplasm in the lumbar spine. Although osteosarcoma can arise in any portion of the skeleton, it very rarely arises in the spinal canal, which accounts for <0.1% of all cases of adult sarcomas. Here, we describe a case of osteosarcoma arising in the L4-5 spinal canal. PATIENT CONCERNS: The present report describes the case of a 55-year-old female patient with osteosarcoma of the L4-5 spinal canal. DIAGNOSES: The patient was initially diagnosed with lumbar spinal stenosis and underwent lumbar fusion at a local hospital. At the 4-month follow-up, the patient reported a marked increase in numbness and pain in the lumbar region and lower limbs. Based on magnetic resonance imaging, we diagnosed a postoperative infectious lesion of the lumbar spine. INTERVENTIONS: The patient underwent surgery for complete removal of the mass lesion. The mass measured 3 × 2.5 × 0.7 cm in size and was located in the L4-5 spinal canal. OUTCOMES: Based on histological and immunohistochemical findings, the diagnosis of osteosarcoma was confirmed by an expert pathology consultant. The patient then received chemotherapy. Postoperative follow-up at 6 months revealed no evidence of recurrent disease or residual side effects from therapy. LESSONS: Osteosarcoma in the L4-5 spinal canal is extremely rare and very difficult to distinguish histologically from benign nervous and fibrous tissue. This is a very valuable case, which highlights the need for orthopedic surgeons to consider this when diagnosing patients with spinal tumors.
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