{"title":"Idiopathic Focal Osteonecrosis of T9 Vertebral Body Mimicking a Malignant Tumor: A Case Report.","authors":"Arvind G Kulkarni, Shankargouda Patil, Aniruddh Agrawal, Sunil Chodavadiya, Priyambada Kumar","doi":"10.13107/jocr.2025.v15.i06.5710","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Occurrence of a focal lytic lesion which is \"hot\" on positron emission tomography (PET) scan is presumed to be neoplastic until proven otherwise. Focal osteonecrosis of vertebral body (VB) without collapse is a rare entity with sparse literature available.</p><p><strong>Case report: </strong>A focal osteolytic lesion in a patient with a history of breast carcinoma, in remission, thought to be metastatic lesion on magnetic resonance imaging and PET-computed tomography (CT), with an inconclusive CT-guided biopsy, was found to be osteonecrosis on histopathology of aggregates of tissue obtained from the T9 VB during open surgery.</p><p><strong>Conclusion: </strong>Osteonecrosis without a VB collapse is a rare diagnosis, but should be considered a differential when examining suspected metastatic lesions in VB.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"185-189"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159658/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.13107/jocr.2025.v15.i06.5710","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Introduction: Occurrence of a focal lytic lesion which is "hot" on positron emission tomography (PET) scan is presumed to be neoplastic until proven otherwise. Focal osteonecrosis of vertebral body (VB) without collapse is a rare entity with sparse literature available.
Case report: A focal osteolytic lesion in a patient with a history of breast carcinoma, in remission, thought to be metastatic lesion on magnetic resonance imaging and PET-computed tomography (CT), with an inconclusive CT-guided biopsy, was found to be osteonecrosis on histopathology of aggregates of tissue obtained from the T9 VB during open surgery.
Conclusion: Osteonecrosis without a VB collapse is a rare diagnosis, but should be considered a differential when examining suspected metastatic lesions in VB.
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