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J La State Med Soc. 2012 Sep-Oct;164(5):251-5.

Large sacral osteoblastoma: a case report and review of multi-disciplinary management strategies.

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1
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, USA.

Abstract

INTRODUCTION:

Osteoblastomas are uncommon primary benign bone tumors. The sacrum is an uncommon site of involvement. We present a case of a large, technically challenging sacral osteoblastoma in a pediatric patient that was managed with en-bloc resection and lumbo-sacral reconstruction showing long-term remission.

CASE REPORT:

A 15-year-old Hispanic male presented to our clinic in May 2006 with low back pain. Imaging revealed a large expansile and erosive mass at the S2 vertebral body. Definitive treatment of the lesion with en-bloc surgical resection was planned after a biopsy that confirmed osteoblastoma. The patient underwent pre-operative embolization and a same-day, two-stage resection of the tumor with lumbosacral instrumentation for pelvic reconstruction. The S1 nerve roots were sacrificed during en-bloc resection of the mass. Post-operatively, the patient developed an areflexic bladder without major motor or sensory impairment. Subsequently, insertion of an artificial urinary sphincter and a colostomy were performed. At the five-year follow up, the patient remains symptom free with no detectable recurrence.

CONCLUSION:

The sacrum is a known, but rare, location for an osteoblastoma. We present a technically challenging case of a pediatric patient with a large sacral osteoblastoma. We highlight the importance of a multidisciplinary approach to ensure a long-term, disease-free outcome.

PMID:
23362588
[Indexed for MEDLINE]
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