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Recurrent adamantinoma in the thoracolumbar spine successfully treated by three-level total en bloc spondylectomy by a single posterior approach

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Abstract

Purpose

Adamantinoma is a low-grade primary malignant bone tumour with slow growth and local recurrence. Its occurrence in the spine is extremely rare, particularly with multilevel involvement. This paper wants to present the first case involving a patient with recurrent thoracolumbar spinal adamantinoma, who underwent a successful three-level spondylectomy for en bloc resection.

Methods

A 24-year-old man with osteolytic masses of T11 and T12 vertebral bodies was performed curettage by a posterior approach in 2008. The pathology report showed the excised neoplasm was a rare adamantinoma. This patient underwent a tumorectomy again because of its local recurrence nearly 3 years later. In 2012, it was unfortunately revealed that the excised tumour had relapsed and had spread to the L1 vertebral body. Due to its repeated recurrence and aggressive lesion, total en bloc spondylectomy (TES) for this malignant tumour was thought to be the best option for preventing repeated recurrence and possible cure. TES for T11–L1 thoracolumbar spine was performed and spinal reconstruction was completed with instrumentation and a titanium mesh cage through a one-stage single posterior approach.

Results

After three-level TES, neurological deficits of the patient demonstrated good recovery and no evidence of adamantinoma recurrence or deformity was found at 2-year follow-up.

Conclusions

This is the first case involving multilevel thoracolumbar spinal adamantinoma with repeated recurrence to be successfully treated by three-level TES by a single posterior approach.

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References

  1. Kahn LB (2003) Adamantinoma, osteofibrous dysplasia and differentiated adamantinoma. Skeletal Radiol 32(5):245–258

    Article  PubMed  Google Scholar 

  2. Mohler DG, Cunningham DC (1997) Adamantinoma arising in the distal fibula treated with distal fibulectomy: a case report and review of the literature. Foot Ankle Int 18(11):746–751

    Article  CAS  PubMed  Google Scholar 

  3. Jain D, Jain VK, Vasishta RK, Ranjan P, Kumar Y (2008) Adamantinoma: a clinicopathological review and update. Diagn Pathol 3:8

    Article  PubMed Central  PubMed  Google Scholar 

  4. Moon NF, Mori H (1986) Adamantinoma of the appendicular skeleton—updated. Clin Orthop Relat Res 204:215–237

    PubMed  Google Scholar 

  5. Dini LI, Mendonca R, Adamy CA, Saraiva GA (2006) Adamantinoma of the spine: case report. Neurosurgery 59(2):E426

    Article  PubMed  Google Scholar 

  6. Nerubay J, Chechick A, Horoszowski H, Engelberg S (1988) Adamantinoma of the spine: a case report. J Bone Joint Surg Am 70(3):467–469

    CAS  PubMed  Google Scholar 

  7. Hazelbag HM, Taminiau AH, Fleuren GJ, Hogendoorn PC (1994) Adamantinoma of the long bones. A clinicopathological study of thirty-two patients with emphasis on histological subtype, precursor lesion, and biological behavior. J Bone Joint Surg Am 76(10):1482–1499

    CAS  PubMed  Google Scholar 

  8. Kawahara N, Tomita K, Murakami H, Demura S (2009) Total en bloc spondylectomy for spinal tumors: surgical techniques and related basic background. Orthop Clin N Am 40(1):47–63

    Article  Google Scholar 

  9. Guo C, Yan Z, Zhang J, Jiang C, Dong J et al (2011) Modified total en bloc spondylectomy in thoracic vertebra tumour. Eur Spine J 20(4):655–660

    Article  PubMed Central  PubMed  Google Scholar 

  10. Liljenqvist U, Lerner T, Halm H, Buerger H, Gosheger G et al (2008) En bloc spondylectomy in malignant tumors of the spine. Eur Spine J 17(4):600–609

    Article  PubMed Central  PubMed  Google Scholar 

  11. Druschel C, Disch AC, Melcher I, Engelhardt T, Luzzati A et al (2012) Surgical management of recurrent thoracolumbar spinal sarcoma with 4-level total en bloc spondylectomy: description of technique and report of two cases. Eur Spine J 21(1):1–9

    Article  PubMed Central  PubMed  Google Scholar 

  12. Fang T, Dong J, Zhou X, McGuire RA Jr, Li X (2012) Comparison of mini-open anterior corpectomy and posterior total en bloc spondylectomy for solitary metastases of the thoracolumbar spine. J Neurosurg Spine 17(4):271–279

    Article  PubMed  Google Scholar 

  13. Tomita K, Kawahara N, Baba H, Tsuchiya H, Fujita T et al (1997) Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors. Spine (Phila Pa 1976) 22(3):324–333

    Article  CAS  Google Scholar 

  14. Casadei R, Mavrogenis AF, De Paolis M, Ruggieri P (2013) Two-stage, combined, three-level en bloc spondylectomy for a recurrent post-radiation sarcoma of the lumbar spine. Eur J Orthop Surg Traumatol 23:S93–100

    Article  PubMed  Google Scholar 

  15. Papagelopoulos PJ, Mavrogenis AF, Galanis EC, Savvidou OD, Inwards CY et al (2007) Clinicopathological features, diagnosis, and treatment of adamantinoma of the long bones. Orthopedics 30(3):211–215

    PubMed  Google Scholar 

  16. Chandrasekar CR, Mohammed R, Rafalla AA, Grimer RJ (2009) Adamantinoma of the calcaneum–a case report. Foot (Edinb) 19(1):58–61

    Article  CAS  Google Scholar 

  17. Frey SP, Hardes J, Ahrens H, Winkelmann W, Gosheger G (2008) Total tibia replacement using an allograft (in a patient with adamantinoma). Case report and review of literature. J Cancer Res Clin Oncol 134(4):427–431

    Article  PubMed  Google Scholar 

  18. Chanplakorn P, Chanplakorn N, Pongtippan A, Jaovisidha S, Laohacharoensombat W (2011) Recurrent epithelioid sarcoma in the thoracic spine successfully treated with multilevel total en bloc spondylectomy. Eur Spine J 20(Suppl 2):S302–S308

    Article  PubMed  Google Scholar 

  19. Disch AC, Schaser KD, Melcher I, Feraboli F, Schmoelz W et al (2011) Oncosurgical results ofmultilevel thoracolumbar en-bloc spondylectomy and reconstruction with a carbon composite vertebral body replacement system. Spine (Phila Pa 1976) 36(10):E647–E655

    Article  Google Scholar 

  20. Sciubba DM, Gokaslan ZL, Black JH 3rd, Simmons O, Suk I et al (2011) 5-Level spondylectomy for en bloc resection of thoracic chordoma: case report. Neurosurgery 69(2):E248–E255

    Google Scholar 

  21. Du ZY, Zang J, Tang XD, Guo W (2010) Experts’ agreement on therapy for bone metastases. Orthop Surg 2(4):241–253

    Article  PubMed  Google Scholar 

  22. Li J, Lv GH, Wang XB, Wang B, Lu C (2010) Delayed paraplegia following correction of severe thoracolumbar kyphotic deformity by posterior vertebral column resection. Orthop Surg 2(1):71–76

    Article  PubMed  Google Scholar 

  23. Disch AC, Schaser KD, Melcher I, Luzzati A, Feraboli F et al (2008) En bloc spondylectomy reconstructions in a biomechanical in vitro study. Eur Spine J 17(5):715–725

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Oda I, Cunningham BW, Abumi K, Kaneda K, McAfee PC (1999) The stability of reconstruction methods after thoracolumbar total spondylectomy. An in vitro investigation. Spine (Phila Pa 1976) 24(16):1634–1638

    Article  CAS  Google Scholar 

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Acknowledgments

The authors are grateful for financial support from the Key Project of Shanghai Science and Technology Commission (No. 12411951300), the Natural Science Foundation of China (No. 30970718, 31170925) and the Program for Outstanding Medical Academic Leader of Shanghai (No. LJ10017).

Conflict of interest

None of the authors has any potential conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China

    Ping-Guo Duan

  2. Division of Spine, Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Ruo-Yu Li, Yun-Qi Jiang, Hui-ren Wang, Xiao-Gang Zhou, Xi-Lei Li, Yi-chao Wang & Jian Dong

Authors
  1. Ping-Guo Duan
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  2. Ruo-Yu Li
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  3. Yun-Qi Jiang
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  4. Hui-ren Wang
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  5. Xiao-Gang Zhou
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  6. Xi-Lei Li
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  7. Yi-chao Wang
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  8. Jian Dong
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Corresponding author

Correspondence to Jian Dong.

Additional information

P.-G. Duan and R.-Y. Li contributed equally to this work.

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Duan, PG., Li, RY., Jiang, YQ. et al. Recurrent adamantinoma in the thoracolumbar spine successfully treated by three-level total en bloc spondylectomy by a single posterior approach. Eur Spine J 24 (Suppl 4), 514–521 (2015). https://doi.org/10.1007/s00586-014-3625-z

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  • DOI: https://doi.org/10.1007/s00586-014-3625-z

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