Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 2

Intractable Neck Pain Due to Osteoblastoma: A Case Report and Review of the Literature

Melek Sezgin 1 ,İsmet As 2 ,F. Demir Apaydın 3 ,Nihat Egemen 4 ,Selim Erekul 5 ,Günşah Şahin 1
1 Mersin Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Mersin, Türkiye
2 Mersin Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Mersi
3 Mersin Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Mersin, Türkiye
4 Ankara Üniversitesi Tıp Fakültesi, Beyin Cerrahi Anabilim Dalı, Ankara
5 Ankara Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Ankara

A 12 year-old girl presented with a 10-month-history of the left lateral neck pain. The patient had been examined by eight physicians and multiple diagnoses had been made before. Despite treatments, neck pain had not been relieved and the intensity of the pain had gradually increased. On admission, there was local tenderness on the left side of the neck and cervical movements were restricted. The neurological examination and routine laboratory tests were normal. Except for decreasing cervical lordosis, of previous plain radiographs and magnetic resonance images of the cervical spine were normal. Based on clinical signs and symptoms, we suspected that the patient had a cervical mass. A soft tissue ultrasonography of the neck showed a suspicious bony hypertrophy or calcification-like lesion in the level of the fourth cervical vertebra. The subsequent computed tomography scanning confirmed a tumour in the left transverse process of the fourth cervical vertebra. After the tumour was excised, its pathological examination revealed osteoblastoma. Neck pain disappeared after surgery. Recurrence was not seen in the final follow-up. Careful clinical and radiologic evaluation should be performed in all pediatric patients with neck pain to rule out bone tumours. Although osteoblastoma is rare, diagnosis is commonly delayed and effective treatment is important to prevent neurologic complications and recurrence.

Keywords : Neck pain, cervical spine tumours and osteoblastoma